Fleshman J W, Kodner I J, Fry R D, Walz B, Gilley M T
Dis Colon Rectum. 1985 Nov;28(11):810-5. doi: 10.1007/BF02555484.
The management of rectal cancer in 102 patients at the Jewish Hospital of St. Louis is reviewed. Therapy combining external irradiation, endocavitary irradiation, local excision, and excisional operation has been used in the treatment of adenocarcinoma of the rectum. Pretreatment evaluation for tumor fixation, ulceration, palpable presacral lymph nodes, distance of tumor from dentate line, size of tumor, and histologic grades was used to assign patients to treatment groups. Local recurrence is less than 2 percent, and two-year tumor-free survival is approximately 87 percent in patients receiving 2000 R or 4500 R preoperatively. Pathologic downstaging of tumors was noted more frequently with 4500 R preoperative irradiation. Endocavitary irradiation appears adequate to treat only favorable lesions. Only tumor fixation and histologic grade of the tumor notably affected survival. A logical plan for choosing the appropriate method of treatment using combined modalities is proposed.
回顾了圣路易斯犹太医院对102例直肠癌患者的治疗情况。联合外照射、腔内照射、局部切除和根治性手术的治疗方法已用于直肠癌腺癌的治疗。根据肿瘤固定情况、溃疡情况、可触及的骶前淋巴结、肿瘤距齿状线的距离、肿瘤大小和组织学分级进行术前评估，以将患者分配至治疗组。接受术前2000拉德或4500拉德照射的患者局部复发率低于2%，两年无瘤生存率约为87%。术前4500拉德照射更常出现肿瘤病理降期。腔内照射似乎仅足以治疗预后良好的病变。仅肿瘤固定情况和肿瘤组织学分级对生存率有显著影响。提出了一个使用联合治疗方法选择合适治疗方案的合理计划。
