Knysh V I, Kim F P, Goldobenko G V, Tsariuk V F, Barsukov Iu A
Khirurgiia (Mosk). 1994 Oct(10):20-3.
From analysis of 490 case records of patients with stage IV A rectal carcinoma, 3 groups of patients were distinguished according to the size of the tumor and the degree of its fixation to the surrounding tissues and growth into the adjacent organs. Such locally spread tumors of the rectum must be subjected to combined treatment: preoperative large-fractional radiotherapy in concurrent local SHF-hyperthermia followed by operation 24-48 hours later. If resectability of the tumor is doubtful, a relieving colostoma is formed in the first stage and distance gammatherapy is applied in a dose of 4 Gy twice a week to a total dose of 32 Gy auring medication with metronidazole and local SHF-therapy. Concurrent intraarterial chemotherapy with 5-fluorouracil (15 mg/kg body weight) has been lately introduced into practice in the treatment of such patients. The results of this complex treatment are evaluated 3-4 weeks after the course is completed.
通过对490例IV A期直肠癌患者的病例记录进行分析，根据肿瘤大小、肿瘤与周围组织的固定程度以及向邻近器官的生长情况，区分出3组患者。这种直肠局部扩散肿瘤必须接受综合治疗：术前进行大分割放疗并同时进行局部射频热疗，然后在24至48小时后进行手术。如果肿瘤的可切除性存疑，则在第一阶段形成缓解性结肠造口术，并在服用甲硝唑和进行局部射频热疗的同时，每周两次给予4 Gy的远距离伽马射线治疗，总剂量为32 Gy。最近，在这类患者的治疗中开始采用5-氟尿嘧啶（15 mg/kg体重）进行同步动脉内化疗。在疗程结束3至4周后评估这种综合治疗的效果。
