Påhlman L, Glimelius B
Kirurgkliniken, Akademiska sjukhuset, Uppsala.
Lakartidningen. 1998 Sep 23;95(39):4216-20.
The treatment of rectal cancer has changed dramatically during the past twenty years. Adjuvant radiotherapy has been shown to reduce the local recurrence rate by approximately 50 per cent, a reduction associated with a 10-20 per cent improvement in overall survival. Most trials designed to evaluate radiotherapy have not been optimised. Use of the modern mesorectal excision procedure in rectal cancer surgery has reduced the local recurrence rate and improved survival in cases treated with surgery alone. The article consists in a review of advances in our knowledge of radiotherapy and the value of improved surgery, and discussion of radiotherapy used in conjunction with optimised surgical treatment.
在过去二十年中，直肠癌的治疗发生了巨大变化。辅助放疗已被证明可将局部复发率降低约50%，这一降低与总生存率提高10%-20%相关。大多数旨在评估放疗的试验并未得到优化。在直肠癌手术中使用现代直肠系膜切除术降低了局部复发率，并提高了单纯手术治疗病例的生存率。本文包括对放疗知识进展和改良手术价值的综述，以及对与优化手术治疗联合使用的放疗的讨论。
