三维适形放疗联合FOLFOX治疗直肠癌的临床效果观察-现代仪器与医疗.PDFVIP

《现代仪器与医疗》 2015年  第21卷   第1期 临床研究 三维适形放疗联合FOLFOX治疗直肠癌的 临床效果观察 张发恩 （广西河池市人民医院，广西河池　547000 ） [ 摘　要 ]　目的：探讨术前三维适形放疗联合FOLFOX 方案治疗直肠癌的临床疗效及治疗安全性。 方法：选取2008 年2 月～2012 年 1 月在我科治疗而且病理证实为局部晚期直肠癌患者65 例，随机 分为适形放疗加化疗组（观察组）35 例，常规放疗加化疗组（对照组）30 例，观察并比较两组的临 床疗效和不良反应情况。结果：两组总有效率(CR+PR) 分别是63.3% 和82.9%。术前肿瘤分期明显降 低，治疗后原诊断为Ｔ3 期的35 例患者中6 例降为Ｔ 1 期，13 例降为Ｔ2 期，16 例仍为Ｔ3 期；其 侵犯淋巴结均有缩小，其中 12 例转阴。对照组放射性膀胱炎、皮肤反应和放射性直肠炎的发生率高 于观察组(P ＜0.05)。结论：术前三维适形放疗联合FOLFOX 方案化疗治疗局部晚期直肠癌的安全有 效的方法，值得临床应用。 [ 关键词 ]　三维适形；FOLFOX 方案；直肠癌 中图分类号：R735.3　文献标识码：A　文章编号：2095-5200（2015）01-033-03 DOI：10.11876/mimt201501011 Three Dimensional-conformal Radiotherapy Combined with FOLFOX chemotherapy for recurrent rectal cancer　ZHANG Fa-en. (The People’s Hospital of Hechi City, Guangxi Hechi, 547000) [Abstract]　Objective: To evaluate the efficacy and compliance of neoadjuvant three-dimensional conformal radiotherapy(3-DCRT) combined with FOLFOX regimen in the management of locally advanced rectal cancer. Method: 65 patients with rectal cancer after radical excision were enrolled whose treated in 2008.2 2012.1. They were randomly divided into two groups, 35 patients in radiochemotherapy with3-DCRT ～ group(observed group) and 30 patients in radiochemotherapy group(control group). The clinical efficacy and side effects were observed and compared. Results: The overall response rate was82.9% in 3-DCRT group and 63.3% in control group,Tumor stages were downstaged significantly. 6 patients in 35 cases whose original diagnosis for T3 downstaged to T1 stage,13 patients downstageed to T2 staged and the lymph nodes involved reduced, including 12 cases turned to negative. The incidences of radiocystitis, skin reaction and radiation proctitis were lower in 3- DCRT group than those in control group(P＜0.05). Conclusion: Concurrent three- dimensional conformal radiotherapy and chemotherapy might be safe and effective in the treatment for rect