Cummings B J
Can J Surg. 1978 Jan;21(1):44-6.
In a number of studies preoperative irradiation of cancer of the rectum has procured 5-year survival rates higher than those obtained with conventional surgical techniques, whether or not the tumour has spread to lymph nodes. There appears, as well, to be a lower rate of local recurrence and possibly of the development of distant metastases. Also, some tumours of questionable operability are reduced in size to make resection possible. The effectiveness of postoperative radiation therapy is not yet firmly established. Radiation therapy as the primary method of treatment of rectal carcinoma has been used at the Princess Margaret Hospital in Toronto in 79 patients over a period of 18 years. The overall 5-year survival rate is 28%; this rises to 38% when the tumour is not fixed but falls to half this figure when fixity of the growth is evident. These results offer grounds for investigating radical radiation therapy as an alternative to surgical methods of dealing with low-lying carcinomas of the rectum.
在多项研究中，无论肿瘤是否已扩散至淋巴结，对直肠癌进行术前放疗所获得的5年生存率均高于采用传统手术技术所取得的生存率。此外，局部复发率以及远处转移的发生率似乎也较低。而且，一些手术可行性存疑的肿瘤会缩小尺寸，从而使切除成为可能。术后放射治疗的有效性尚未得到确凿证实。多伦多玛格丽特公主医院在18年期间对79例患者采用放射治疗作为直肠癌的主要治疗方法。总体5年生存率为28%；当肿瘤未固定时，这一比例升至38%，但当肿瘤明显固定时，该比例降至上述数字的一半。这些结果为研究根治性放射治疗作为治疗低位直肠癌的手术方法的替代方案提供了依据。
