Ⅲ期中上段直肠癌Dixon式术后不同治疗方式疗效分析(1)

http://www.100md.com 2017年6月11日 医学信息 2017年第23期

     摘要：目的 比较两种不同治疗方式在Ⅲ期中上段直肠癌Dixon式术后辅助治疗的近期疗效及不良反应。方法 回顾性分析60例患者，观察组32例：盆腔放疗46Gy后在吻合口瘤床周围三维适形加量至56～60 Gy；对照组28例：盆腔放疗50 Gy。两组均于放疗同时口服希罗达1600 mg/m2·d，1～5 d/w。放疗结束，序贯FOLFOX4方案全身化疗4周期。结果 观察组3年总生存率(OS)为85%，中位生存期(MST)为53个月(95%CI，46.836～59.800)；对照组分别为79%和49個月(95%CI，42.116～58.763)；两组比较差异无统计学意义(χ2=0.229，P=0.632)。观察组3年局部无进展生存率(LRPFS)为70%，中位无进展生存期(MSTL)为38个月(95%CI，35.215～40.785)；对照组分别为27%和36个月(95%CI，29.443～42.557)；两组比较差异有统计学意义(χ2=3.859，P=0.049)；不良反应差异均无统计学意义(P值均>0.5)；两组吻合口复发等治疗失败率总体比较差异无统计学意义(χ2=4.152，P=0.386)。结论 Ⅲ期中上段直肠癌Dixon式术后，盆腔普通放疗基础上三维适形加量较单纯普通放疗有较好近期疗效。
, 百拇医药
    关键词：直肠肿瘤；同步放化疗；适形放疗；放射治疗剂量；生存率

    中图分类号：R735.3+7 文献标识码：A 文章编号：1006-1959(2017)23-0035-04

    Efficacy Analysis of Different Treatment Methods for Stage Ⅲ Upper and Middle Rectal Cancer after Dixon Operation

    ZHANG Ke-bin，LI Xiao-ying，DU Jie，PENG Ying，GOU Xian-bi

    (Department of Oncology，General Hospital of Shuicheng Mining Holding Group Co.， Ltd.，Liupanshui 553000，Guizhou，China)
, 百拇医药
    Abstract：Objective To compare the short-term efficacy and side effects of Dixon type adjuvant therapy for two different treatment modalities in stage Ⅲ upper rectal cancer.Methods Sixty patients were retrospectively analyzed.The observation group consisted of 32 cases：pelvic radiotherapy 46Gy after the anastomotic tumor bed around the three-dimensional fitness to 56～60Gy；control group of 28 cases：pelvic radiotherapy 50 Gy.Both groups were treated with radiotherapy at the same time in Xiluoda 1600 mg/m2/d，1～5d/w.End of radiotherapy，sequential FOLFOX4 regimen for systemic chemotherapy for 4 cycles.Results The 3 year overall survival rate(OS)of the observation group was 85%，the median survival time(MST)was 53 months(95% CI，46.836-59.800)，79% in the control group and 49 months(95% CI，42.116～58.763).There was no significant difference between the two groups(χ2=0.229，P=0.632).The 3 year local progression free survival rate(LRPFS)was 70% in the observation group，and the median progression free survival(MSTL)was 38 months(95%CI，35.215～40.785)，while the control group was 27% and 36 months(95%CI，29.443～42.557)，respectively；there was significant difference between two groups(χ2=3.859，P=0.049)；adverse reactions had no statistically significant difference(P>0.5)；Two groups of anastomotic recurrence treatment failure rate had no significant overall difference(χ2=4.152，P=0.386).Conclusion In the upper stage III rectal cancer Dixon postoperative pelvic radiotherapy，the common basis of three-dimensional conformal radiotherapy compared with ordinary dosage has better curative effect in the near future., http://www.100md.com(张克斌 李晓莹 杜杰 彭英 苟先碧)

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