Kamikonya N, Izumi M, Tusboi K, Nogi K, Miyamoto Y, Nakao N
Department of Radiology, Hyogo College of Medicine.
Nihon Igaku Hoshasen Gakkai Zasshi. 1998 Aug;58(9):503-8.
One hundred and fifteen patients with middle and lower rectal cancer were treated with preoperative High-dose-rate intraluminal brachytherapy (HDRIBT) and radical operation. Patients were divided into a middle-dose group (group A; 30-40 Gy; n = 94) and a high-dose group (group B; 60-80 Gy; n = 18). A control group of 115 rectal cancer patients who received no irradiation prior to radical surgery was used for comparison (group C). The rate of sphincter-saving resection was 71% in group A, 61% in group B, and 42% in group C (group A vs. group C; p < 0.0001). The local recurrence rate at 5 years was 10% in group A, 6% in group B, and 26% in group C (group A vs. group C; p = 0.005). The 5-year survival rate was similar among the three groups. These results suggest that preoperative HDRIBT contributed to the improvement of local control but not to survival after radical resection of rectal cancer. The application of HDRIBT might be useful to restore intestinal continuity for rectal cancer.
115例中低位直肠癌患者接受了术前高剂量率腔内近距离放射治疗(HDRIBT)及根治性手术。患者被分为中剂量组(A组;30 - 40 Gy;n = 94)和高剂量组(B组;60 - 80 Gy;n = 18)。选取115例根治性手术前未接受放疗的直肠癌患者作为对照组(C组)进行比较。A组保肛切除率为71%,B组为61%,C组为42%(A组与C组比较;p < 0.0001)。5年局部复发率A组为10%,B组为6%,C组为26%(A组与C组比较;p = 0.005)。三组5年生存率相似。这些结果表明,术前HDRIBT有助于改善直肠癌根治术后的局部控制,但对生存无影响。HDRIBT的应用可能有助于恢复直肠癌患者的肠道连续性。