Kiyomatsu Tomomichi, Watanabe Toshiaki, Muto Tetsuichiro, Nagawa Hirokazu
Department of Surgical Oncology, University of Tokyo Graduate School of Medicine, 7-3-1, Hongo, Bunkyokui, Tokyo, Japan 13-8655.
Am J Surg. 2007 Oct;194(4):542-8. doi: 10.1016/j.amjsurg.2007.01.030.
This study evaluated the difference of postoperative complications according to the radiation technique after preoperative radiotherapy for rectal cancer.
Among 224 patients with rectal cancer who underwent preoperative radiotherapy, 159 patients were treated with the 2-portal technique and 65 patients with the 4-portal technique. Comparison was performed between these 2 groups.
The 5-year disease-free survival and local recurrence rate showed no difference between the 2 groups. There was also no difference in postoperative mortality. However, the 4-portal group had a significantly lower morbidity rate of 36.9% than the 2-portal group of 54.1% (P = .02). The rate of major complications that needed reoperation was also significantly lower in the 4-portal group (0%) than the 2-portal group (11.9%) (P = .01). The anastomotic leakage rate was significantly lower in the former (2.8% vs 20.0%, P = .033).
The 4-portal technique is a better technique than the 2-portal technique for decreasing postoperative complications in preoperative radiotherapy for rectal cancer.
本研究评估了直肠癌术前放疗后根据放疗技术不同所产生的术后并发症差异。
在224例行术前放疗的直肠癌患者中，159例采用双野技术治疗，65例采用四野技术治疗。对这两组进行比较。
两组的5年无病生存率和局部复发率无差异。术后死亡率也无差异。然而，四野组的发病率显著低于双野组，分别为36.9%和54.1%（P = 0.02）。需要再次手术的严重并发症发生率在四野组（0%）也显著低于双野组（11.9%）（P = 0.01）。前者的吻合口漏发生率显著更低（2.8%对20.0%，P = 0.033）。
在直肠癌术前放疗中，四野技术在降低术后并发症方面优于双野技术。
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