术前新辅助放化疗在T3期直肠癌患者中的疗效研究

摘要

ObjectiveTo investigate clinical efficacy of the preoperative neoadjuvant chemoradio therapy for patients with T3 stage rectal cancer.MethodsA total of 137 rectal cancer patients at T3 stage without distant metastases were enrolled retrospectively,and they were divided into neoadjuvant chemoradio therapy groups(n=76)and the no neoadjuvant chemoradio therapy(control)group(n=61).After preoperative neoadjuvant chemoradio therapy was used,the patients were assessed and operated. Peri-operative complications were recorded after surgery in all patients. All the patients were regularly followed up,meanwhile the mortality,recurrence and loss to follow-up were recorded. ResultsIn the neoadjuvant chemoradiotherapy group,tumor sizes in 53(69.7%)patients reduced after neoadjuvant chemotherapy,the sphincter-preserving surgery rate was significantly higher than control group(44.7% vs.13.1%, P<0.05).There were no significant differences of peri-operative complications between two groups(P>0.05). Neoadjuvant chemotherapy and three year local recurrence rate(26.3%)was significantly lower than the control group (37.7%)(P<0.05).ConclusionPreoperation neoadjuvant chemotherapy in patients with stage T3 rectal cancer can increase sphincter-preserving surgery rate,and improve the long-term outcome.%目的：对术前新辅助放化疗用于T3期直肠癌患者的临床疗效进行观察。方法纳入T3期且无远处转移的直肠癌患者137例，根据是否接受术前新辅助放化疗分为新辅助放化疗组（n=76）及无新辅助放化疗对照组（n=61）。术前新辅助放化疗按标准方案进行，结束后评估患者情况并进行直肠癌根治手术。所有患者手术后观察其围术期并发症情况，并纳入随访，记录患者死亡、复发情况。结果新辅助放化疗组中53例（69.7%）出现肿瘤体积缩小，接受保留肛门手术比例高于对照组（44.7% vs 13.1%，P<0.05）。2组患者之间围术期并发症发生率相似，差异无统计学意义（P>0.05）。新辅助放化疗组3年肿瘤局部复发率（26.3%）显著低于对照组（37.7%），差异有统计学意义（P<0.05）。结论 T3期直肠癌患者手术前接受新辅助放化疗可增加保肛手术比例，改善远期预后。