Pfeiffer Per, Baatrup Gunnar, Jensen Helle Anita, Kronborg Ole
Odense Universitetshospital, Onkologisk Afdeling.
Ugeskr Laeger. 2006 May 8;168(19):1857-60.
Patients with locally advanced rectal cancer (LARC) have a poor prognosis. Preoperative radiotherapy may shrink the tumour and make subsequent resection possible. The use of modern principles of preoperative radiotherapy in combination with chemotherapy and an active surgical attitude increases the chance for radical surgery and cure.
A single-institution, prospective evaluation of a new treatment strategy in patients with LARC was done.
From 1998 to 2000, 20 patients with LARC were treated with high-dose radiochemotherapy (60 Gy and chemotherapy, UFT/leucovorin), and resectability was evaluated four to six weeks after termination of radiochemotherapy. Sixty percent of the patients subsequently had microscopic radical surgery.
Patients with LARC should preferably be treated with high-dose preoperative radiotherapy in combination with chemotherapy. Evaluation of resectability should be performed at least four weeks after termination of radiotherapy. This strategy, in combination with modern surgical techniques, increases the probability of success of radical surgery and cure.
局部晚期直肠癌（LARC）患者预后较差。术前放疗可使肿瘤缩小，从而使后续切除成为可能。采用现代术前放疗原则联合化疗以及积极的手术态度可增加根治性手术和治愈的机会。
对LARC患者的一种新治疗策略进行了单机构前瞻性评估。
1998年至2000年，20例LARC患者接受了高剂量放化疗（60 Gy及化疗，优福定/亚叶酸钙），并在放化疗结束后4至6周评估可切除性。随后60%的患者接受了显微镜下根治性手术。
LARC患者最好接受高剂量术前放疗联合化疗。应在放疗结束后至少4周进行可切除性评估。这种策略与现代手术技术相结合，可提高根治性手术和治愈的成功率。
