Objective To evaluate the efficacy of neoadjuvant therapy plus surgery and surgery plus postoperative adjuvant therapy for phase Ⅱ and Ⅲ low rectal cancer. Methods A retrospective analysis was performed on the clinical data of patients with phase Ⅱ and Ⅲ( T3 , T4 and/or N1 , N2 ) low rectal cancer who were admitted to our hospital from 2009 to 2013.Those patients were divided into group A (n=98) and group B ( n=93) according to the treatment method. Group A received neoadjuvant therapy followed by radical resection. Group B was treated with radical resection and postoperative adjuvant therapy. Between-group comparison was made byχ2 test or Fisher′s exact probability test. The Kaplan-Meier method was used to analyze the survival rates. Results The follow-up rate was 92.1%. The 3-year local recurrence ( LR) and distant metastasis (DM) rates were significantly lower in group A than in group B (12.9% vs. 32.2%,P=0.002;13.5% vs. 37.8%, P= 0.001 ) . The 3-year overall survival and disease-free survival rates were significantly improved in group A than in group B (84.7% vs. 69.9%,P=0. 022;77. 6% vs. 50. 3%,P=0. 004) . Conclusions Neoadjuvant therapy is a safe and reliable treatment approach for phase Ⅱ and Ⅲ low rectal cancer, which can significantly reduce LR and DM rates and prolong the survival time.%目的 评价Ⅱ、Ⅲ期低位直肠癌新辅助治疗加手术与手术加术后辅助治疗的效果.方法 回顾分析本院2009—2013年收治的Ⅱ、Ⅲ期(T3、T4和/或N1、N2)低位直肠癌患者资料.根据治疗手段分为A、B组,A组为行新辅助治疗后行根治性手术切除患者共98例,B组为直接行根治性手术切除后行术后辅助治疗患者共93例.采用χ2检验或Fisher′s精确概率法进行组间比较,Kaplan-Meier法生存分析.结果 随访率92.1%,A组3年LR、DM率均低于B组,分别为12.9%:32.2%(P=0.002)、13.5%:37.8%(P=0.001);A组生存期优于B组,3年OS、DFS率分别为84.7%:69.9%(P=0.022)、77.6%:50.3%(P=0.004).结论 Ⅱ、Ⅲ期低位直肠癌患者新辅助治疗可明显降低LR、DM率,延长生存期,是安全可靠的治疗方案.
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