[可手术切除的直肠癌的术前和术后放疗]

[Pre- and postoperative radiotherapy of operable carcinoma of the rectum].

作者信息

Latini P, Checcaglini F, Panizza B M, Maranzano E, Aristei C, Perrucci E, Trancanelli V, Mercati U

机构信息

U.O. Radioterapia Oncologica, Policlinico-Ospedale, Perugia.

出版信息

Radiol Med. 1991 Apr;81(4):515-9.

PMID:2028044

Abstract

This was a non-randomized prospective study on the "sandwich" radiosurgical treatment of resectable rectal and rectosigmoid carcinomas. From December 1984 to December 1989, 100 patients were treated 86 of them are now evaluable. Mean follow-up was 38 months (range: 9-69). Surgery was abdomino-perineal resection in 33 cases and anterior resection in 53 cases. Radiotherapy was preoperative pelvic irradiation, with a single 500-Gy fraction, the day before surgery. To stages B2, C1 and C2 patients (Astler and Coller) postoperative radiotherapy was administered for a total dose of 4500 Gy (180 Gy/fraction, 5 fractions/week), with box technique, from a Co 60 unit or Linear Accelerator (photon 18 MV). Preliminary results indicate 8% (7/86) local recurrences and 9.3% (8/86) distant metastases. Five-year actuarial disease-free survival is 63.2% +/- 8 for stage B1, 55.6% +/- 19 for stage B2, and 40.2% +/- 13 for stages C1 + C2. Overall 5-year actuarial disease-free survival is 53% +/- 10. No lethal or severe complications were observed following treatment.

摘要

这是一项关于可切除的直肠和直肠乙状结肠癌“三明治”放射外科治疗的非随机前瞻性研究。1984年12月至1989年12月，共治疗了100例患者，其中86例目前可进行评估。平均随访时间为38个月（范围：9 - 69个月）。手术方式为腹会阴联合切除术33例，前切除术53例。放疗采用术前盆腔照射，手术前一天单次给予500 Gy剂量。对于B2、C1和C2期患者（阿斯特勒和科勒分期），术后放疗总剂量为4500 Gy（180 Gy/分次，每周5次），采用盒式技术，由钴60装置或直线加速器（18 MV光子）进行。初步结果显示局部复发率为8%（7/86），远处转移率为9.3%（8/86）。B1期患者的5年无病生存率精算值为63.2%±8%，B2期为55.6%±19%，C1 + C2期为40.2%±13%。总体5年无病生存率精算值为53%±10%。治疗后未观察到致命或严重并发症。