Cedermark B, Johansson H, Rutqvist L E, Wilking N
Department of Surgery, Karolinska Hospital, Stockholm, Sweden.
Cancer. 1995 May 1;75(9):2269-75. doi: 10.1002/1097-0142(19950501)75:9<2269::aid-cncr2820750913>3.0.co;2-i.
From 1980 to 1987, 849 patients with clinically resectable rectal adenocarcinoma were randomized into a controlled clinical trial to evaluate the role of preoperative radiotherapy.
Patients were given either 25 Gy during 5 to 7 days before surgery or underwent surgery alone.
At a median follow-up time of 107 months (range, 62-144 months) the incidence of pelvic recurrence among 684 "curatively" operated patients was significantly lower among those who also received radiotherapy (P < 0.001) in all Dukes' stages. No significant difference was observed between the treatment groups with regard to frequency of distant metastases or overall survival. The time to local recurrence or distant metastasis and survival was significantly prolonged in the irradiated group. However, the postoperative mortality was 8% in the radiotherapy group compared with 2% in the surgery only group (P = 0.01).
Preoperative short term radiotherapy reduced the incidence of pelvic recurrences and prolonged survival related to rectal cancer compared with surgery alone. The postoperative morbidity was significantly higher in the irradiated group.
1980年至1987年，849例临床可切除的直肠腺癌患者被随机纳入一项对照临床试验，以评估术前放疗的作用。
患者在手术前5至7天接受25 Gy放疗或仅接受手术。
在中位随访时间107个月（范围62 - 144个月）时，684例“根治性”手术患者中，所有Dukes分期中接受放疗的患者盆腔复发率显著低于未接受放疗者（P < 0.001）。治疗组在远处转移频率或总生存率方面未观察到显著差异。放疗组局部复发或远处转移时间及生存期显著延长。然而，放疗组术后死亡率为8%，而单纯手术组为2%（P = 0.01）。
与单纯手术相比，术前短期放疗降低了直肠癌盆腔复发率并延长了生存期。放疗组术后发病率显著更高。
