高汉晶,杨丽,闫争

• 1:天津市第四中心医院放疗科

摘要(Abstract)：

目的探讨卡培他滨辅助三维适形放疗(3-dimensional conformal radiotherapy,3D-CRT)治疗Miles术后Ⅲ期直肠癌疗效及安全性。方法选取Miles术后Ⅲ期直肠癌患者130例,以随机区组法分为对照组(65例)和试验组(65例),分别采用单纯3D-CRT,6 MV照射总剂量为50 Gy,总照射次数25次,每周5次和卡培他滨辅助3DCRT 1 600 mg/(m2·d),d1-14,21 d为1个周期,共行2个周期。比较两组患者总生存率、无瘤生存率、远处转移率、局部复发率、治疗后KPS评分及不良反应发生率等。结果试验组患者3年总生存率(92.3%vs 80.0%)和3年无瘤生存率(81.5%vs 61.5%)均高于对照组,差异均具有统计学意义(均P<0.05)。试验组3年远处转移率(13.8%vs 30.6%)和局部复发率(4.6%vs 21.5%)均低于对照组(均P<0.05)。两组患者治疗后KPS评分(75.82±10.12 vs 77.10±10.61)比较差异无统计学意义(P>0.05),恶心/呕吐、腹泻及泌尿生殖系统不良反应发生率比较差异均无统计学意义(均P>0.05)。试验组骨髓抑制发生率高于对照组(P<0.05)。结论卡培他滨辅助3D-CRT治疗Miles术后Ⅲ期直肠癌可有效延长生存时间,降低转移复发风险,且未导致严重不良反应发生。

关键词(KeyWords)： 直肠肿瘤/治疗;放射疗法,适形;手术后期间;投药,口服;脱氧胞苷/类似物和衍生物;脱氧胞苷/治疗应用;综合疗法;安全;治疗结果

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 高汉晶,杨丽,闫争

DOI: 10.13267/j.cnki.syzlzz.2017.03.007

参考文献(References)：

• [1]Torre LA,Bray F,Siegel RL,et al.Global cancer statistics,2012[J].CA Cancer J Clin,2015,65(2):87-108.
• [2]Shi L,Zhao J,Lu Q,et al.Initial hepatic artery infusion and systemic chemotherapy for asymptomatic colorectal cancer with un-resectable liver metastasis[J].Int J Clin Exp Med,2015,8(1):1000-1008.
• [3]Wang T,Nan H,Zhang C,et al.Aidi injection combined with FOLFOX4 chemotherapy regimen in the treatment of advanced colorectal carcinoma[J].J Cancer Res Ther,2014,10(Suppl 1):52-55.
• [4]万德森.临床肿瘤学[M].2版.北京:科技出版社,2005:348-349.
• [5]孙燕,周际昌.临床肿瘤内科手册[M].北京:人民卫生出版社,2003:102-104.
• [6]任骅,金晶,王鑫,等.术前同步放化疗是直肠癌标准治疗模式[J].实用肿瘤杂志,2013,28(1):20-23.
• [7]Siegel RL,Miller KD,Jemal A.Cancer statistics,2015[J].CA Cancer J Clin,2015,65(1):5-29.
• [8]Zhang G,Zhou X,Lin C.Efficacy of chemotherapy plus bevacizumab as first-line therapy in patients with metastatic colorectal cancer:a meta-analysis and up-date[J].Int J Clin Exp Med,2015,8(1):1434-1445.
• [9]Liu S,Zheng R,Zhang M,et al.Incidence and mortality of colorectal cancer in China,2011[J].Chin J Cancer Res,2015,27(1):22-28.
• [10]Carreres-Prieto M,Lopez-Sisamon D,Layos-Romero L.Interstitial lung disease induced by raltitrexed-oxaliplatin based chemotherapy for colorectal cancer:a case report[J].Farm Hosp,2015,39(2):118-119.
• [11]Huh JW,Lim SW,Kim HR,et al.Effects of postoperative adjuvant radiotherapy on recurrence and survival in stageⅢrectal cancer[J].J Gastrointest Surg,2011,15(6):963-970.
• [12]Sejin Park,Yun Sik Lee.Analysis of the prognostic effectiveness of a multivisceral resection for locally advanced colorectal cancer[J].J Korean Soc Coloproctol,2011,27(1):21.
• [13]Hofheinz RD,Wenz F,Post S,et al.Chemoradiotherapy with capecitabine versus fluorouracil for locally advanced rectal cancer:a randomized,multicentre,non-inferiority,phase 3 trial[J].Lancet Oncol,2012,13(6):579-588.