Påhlman L, Glimelius B, Ginman C, Graffman S, Adalsteinsson B
Acta Radiol Oncol. 1985 Jan-Feb;24(1):35-9. doi: 10.3109/02841868509134362.
In a series of 328 patients with adenocarcinoma of the rectum and rectosigmoid, 39 had a tumour which was considered locally non-resectable (19 patients) or borderline resectable (20 patients). Twenty-eight of these patients received radiation therapy with a daily target dose of 2 Gy up to a total of 46 Gy. If the tumour was still considered non-resectable 3 weeks later, radiation therapy was usually continued up to a total dose of 64 Gy together with 5-fluorouracil. Fifteen patients with a non-resectable tumour received radiation therapy up to a total dose of either 46 Gy (7 patients) or 64 Gy (8 patients). Only two patients underwent resection. Of the 20 patients with a tumour that was considered borderline resectable, 13 received 46 Gy. Nine patients in this group were radically resected. Totally 11 tumours were resected, constituting 39 per cent of the patients who were treated up to 46 Gy or more. Truly locally inoperable tumours in this series were thus rarely converted to extirpative tumours by means of radiation therapy. Most patients with a tumour considered borderline resectable seemed to benefit from the treatment. In addition, the palliative effect of radiation therapy was excellent.
在一组328例直肠和直肠乙状结肠腺癌患者中，39例患者的肿瘤被认为局部不可切除（19例）或边界可切除（20例）。其中28例患者接受了放射治疗，每日靶剂量为2Gy，总剂量达46Gy。如果3周后肿瘤仍被认为不可切除，通常继续放疗至总剂量64Gy，并联合5-氟尿嘧啶。15例不可切除肿瘤患者接受了总剂量为46Gy（7例）或64Gy（8例）的放射治疗。仅2例患者接受了手术切除。在20例被认为边界可切除肿瘤的患者中，13例接受了46Gy的放疗。该组中有9例患者接受了根治性切除。总共11例肿瘤被切除，占接受46Gy或更高剂量治疗患者的39%。因此，在这组病例中，真正局部无法手术的肿瘤很少通过放疗转变为可切除肿瘤。大多数被认为边界可切除肿瘤的患者似乎从治疗中获益。此外，放射治疗的姑息效果极佳。
