Izar F, Fourtanier G, Pradere B, Chiotasso P, Bloom E, Fontes-Dislaire I, Bugat R, Daly N
Department of Radiotherapy, Centre Claudius Regaud, Toulouse, France.
World J Surg. 1992 Jan-Feb;16(1):106-11; discussion 111-2. doi: 10.1007/BF02067122.
From January, 1975 to December, 1987, 241 patients with rectal cancer underwent pre-operative irradiation and surgical resection. The radiation was delivered with 25 MeV photons, 5 days per week by 2.4 grays fractions up to a total dose of 36 grays. Surgery was curative in 195 patients; 57% had abdomino-perineal resection. Irradiation had to be discontinued in 3 patients and 4 patients subsequently developed severe acute ileitis. Postoperative mortality rate was 2.9%. The most frequent postoperative complications were delayed healing of abdominal wounds (18%) and perineal wounds (14%). Severe late complications occurred in 27 (13%) patients. The incidence of intestinal obstruction was 5%. Follow-up survivors ranged from 18 months to 13 years. Local failure occurred in 24 (12%) of the 195 patients. Local failure rates were 10% for Dukes' A tumors, 11.6% for Dukes' B, and 22.7% for Dukes' C tumors. Five and 10 year actuarial survival rates after curative surgery were 70% and 52%. The Dukes' classification was the only factor that influenced survival.
1975年1月至1987年12月，241例直肠癌患者接受了术前放疗和手术切除。放疗采用25兆电子伏光子，每周5天，每次2.4戈瑞，总剂量达36戈瑞。195例患者手术治愈；57% 接受了腹会阴联合切除术。3例患者放疗中断，4例随后发生严重急性回肠炎。术后死亡率为2.9%。最常见的术后并发症是腹部伤口（18%）和会阴部伤口（14%）愈合延迟。27例（13%）患者出现严重晚期并发症。肠梗阻发生率为5%。随访存活者时间为18个月至13年。195例患者中有24例（12%）发生局部复发。Dukes' A期肿瘤局部复发率为10%，Dukes' B期为11.6%，Dukes' C期为22.7%。根治性手术后5年和10年精算生存率分别为70%和52%。Dukes分期是影响生存的唯一因素。
