Lester S G
J Natl Med Assoc. 1988 Oct;80(10):1090-3.
In spite of advances in surgical technique and patient management, there continues to be a high rate of local recurrence for the advanced stages of rectal and colon carcinomas. The addition of radiotherapy to the treatment of colorectal carcinoma, however, has diminished the local recurrence rate; the acute and chronic toxicity is tolerable, and the patients with higher stages benefit from the combined modality. It is recommended that modified Astler-Coller stages B2 or greater receive some form of adjuvant radiotherapy. The ideal sequencing and the benefit of combining radiation with chemotherapy has not yet been determined. The use of intraoperative radiotherapy is very promising and continues to be investigated for initially unresectable lesions and recurrent lesions.
尽管手术技术和患者管理取得了进展，但直肠癌和结肠癌晚期的局部复发率仍然很高。然而，在结直肠癌治疗中加入放疗已降低了局部复发率；急性和慢性毒性是可耐受的，晚期患者从联合治疗模式中获益。建议改良的阿斯特勒-科勒分期为B2期或更高分期的患者接受某种形式的辅助放疗。放疗与化疗联合的理想顺序和益处尚未确定。术中放疗的应用前景广阔，目前仍在针对初始不可切除病变和复发性病变进行研究。
