Ahmad N R, Nagle D A
Department of Radiation Oncology (Ahmad) and Division of Colorectal Surgery (Nagle), Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA 19007, USA.
Semin Radiat Oncol. 1998 Jan;8(1):36-8. doi: 10.1016/s1053-4296(98)80035-0.
Radiation therapy followed by local excision results in local control rates that appear comparable to those of local excision alone (in highly selected patients) or local excision followed by adjuvant radiation therapy. A significant drawback of this approach, however, is the potential loss of important histological information, such as risk of lymph node metastasis, depth of tumor penetration, and presence of lymphatic or vascular invasion. Radiation therapy followed by local excision may be an option for treatment of more advanced T3 rectal cancers in patients who either refuse radical surgery or are medically unfit. The available data in the literature do not support the routine use of local excision after radiation therapy in otherwise healthy patients with locally advanced rectal cancer.
放疗后行局部切除，其局部控制率似乎与单纯局部切除（在经过严格筛选的患者中）或局部切除后行辅助放疗的局部控制率相当。然而，这种方法的一个显著缺点是可能会丢失重要的组织学信息，如淋巴结转移风险、肿瘤浸润深度以及淋巴管或血管侵犯情况。对于拒绝根治性手术或身体状况不适合的患者，放疗后行局部切除可能是治疗更晚期T3直肠癌的一种选择。文献中的现有数据不支持在其他方面健康的局部晚期直肠癌患者中常规采用放疗后局部切除的方法。
