Sischy B
Cancer. 1982 Dec 1;50(11 Suppl):2631-7.
Surgery remains the mainstay in the management of carcinoma of the rectum. However, in spite of many improvements in techniques and anesthesia over the last fifty years, progress as regards increasing survival has been slow. Local recurrence and systemic disease remain the challenge. It appears that radiation therapy has a very definite role in the reduction of local recurrence. The part of radiation therapy presurgically and postsurgically and the incorporation of both in the 'sandwich technique' is reviewed. The use of chemotherapeutic agents for radiosensitization in an effort to improve the results of radiation therapy is described. Consideration is given to management of rectal carcinoma by radiation alone, in particular the endocavitary technique as a viable option to surgery in selected cases. Additional newer techniques such as intraoperative therapy are explained and the role that cooperative studies may take in answering some of the questions concerning the optimum sequence of radiotherapy and surgery are discussed.
手术仍然是直肠癌治疗的主要手段。然而，尽管在过去五十年里技术和麻醉方面有了许多改进，但在提高生存率方面进展缓慢。局部复发和全身性疾病仍然是挑战。放射治疗在降低局部复发方面似乎具有非常明确的作用。本文综述了术前和术后放射治疗的作用以及两者在“三明治技术”中的结合应用。描述了使用化疗药物进行放射增敏以提高放射治疗效果的情况。考虑了单纯放射治疗直肠癌的方法，特别是腔内技术作为某些特定病例中可行的手术替代方案。解释了诸如术中治疗等其他更新的技术，并讨论了合作研究在回答一些关于放疗和手术最佳顺序问题中可能发挥的作用。
