新辅助化放疗在局部进展期低位直肠癌保留肛门括约肌作用的研究
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罗琪, 张颂恩, 魏黎煜
直肠癌;新辅助化放疗;保留肛门括约肌术,罗琪,张颂恩,魏黎煜,罗琪,通讯作者:,电话:,收稿日期:,接受日期:,Roleofsp
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罗琪, 张颂恩, 魏黎煜, 厦门大学附属中山医院 福建医科大学厦门中山医院普外科 福建省厦门市 361004
罗琪, 厦门大学附属中山医院博士, 教授, 主要从事胃肠道肿瘤、乳腺肿瘤的诊治.
通讯作者: 罗琪, 361004, 福建省厦门市湖滨南路209号, 厦门大学附属中山医院普外科. luoqi@medmail.com.cn
电话: 0592-2292042
收稿日期: 2006-05-29 接受日期: 2006-06-19
Role of sphincter preserving surgery with neoadjuant chemoradiotherapy for locally advanced low rectal cancer
Qi Luo, Son-En Zhang, Li-Yu Wei
Qi Luo, Son-En Zhang, Li-Yu Wei, Department of General Surgery, Zhongshan Hospital of Xiamen University, Xiamen 361004, Fujian Province, China
Correspondence to: Dr. Qi Luo, Department of General Surgery, Zhongshan Hospital of Xiamen University, 209 Hubin South Road, Xiamen 361004, Fujian Province,China. luoqi@medmail.com.cn
Received: 2006-05-29Accepted: 2006-06-19
AbstractAIM:To evaluate the role of the sphincter preserving surgery with neoadjuvant chemoradiotherapy in locally advanced low rectal cancer.
METHODS: Forty-two patients with T3 and T4 low rectal cancer were treated by pre-operative radiotherapy to pelvis, 2 Gy daily up to 40-46 Gy in 4 weeks concomitantly with oral administration of capecitabine (CAP) at 1250 mg/m2 bid for 10 weeks (group A). Twenty-one patients were treated by the same chemoradiotherapy after operation (group B).
RESULTS: Neoadjuvant chemoradiotherapy (NCR) was successfully completed in group A. Among the 42 patients, tumor lesions disappeared in 5 cases, so they didn’t receive operation. Curative resection was carried out in the remaining 37 patients, of which 33 received the sphincter-saving resection (SSR) and 4 received abdomino-perineal resection (APR). The rate of sphincter preservation was 89.2% in group A. Of the 21 patients in group B, 11 received SSR and 10 received APR. The rate of sphincter preservation was 52.4% in group B.
CONCLUSION: NCR shows high efficacy in tumor down-staging and shrinkage of tumor mass, and improves the resection rate and sphincter preservation ......
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