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目的:观察直肠癌术后复发患者简化调强放疗(sIMRT)同步卡培他滨化疗的近期疗效和不良反应。方法:33例直肠癌术后复发患者均行sIMRT〔先行盆腔淋巴引流区及直肠周围放疗(45～50)Gy/(25f.5w),复发病灶局部加量18～20Gy,(1.8～2.0)Gy/次,5次/周,总剂量达63～70Gy〕,并同步卡培他滨化疗(1 000mg/m2,从放疗第1天开始,连服14d,休息7d为1个周期,放疗期间口服2个周期)。放疗结束后行同方案巩固化疗2个周期。结果:全部患者均完成治疗,33例患者中CR 5例(15.2%),PR 20例(60.6%),NC 6例(18.2%),PD 2例(6.1%),总有效率75.8%。血清CEA下降50%并维持≥1个月者21例(84.0%)。治疗后临床症状改善和明显好转29例(87.9%)。主要不良反应是血液学毒性、消化道反应、急性膀胱炎和手足综合征等,均可耐受。结论:调强放疗联合卡培他滨同步化疗治疗直肠癌术后复发患者,不良反应轻,近期疗效确切,值得在临床上进一步探讨应用。
Objective: To observe the short-term curative effect and side effects of simplified intensity-modulated radiation therapy (sIMRT) and simultaneous capecitabine chemotherapy in patients with recurrent postoperative recurrence. Methods: Thirty-three patients with recurrence of rectal cancer underwent sIMRT (advanced pelvic lymphatic drainage and peri-rectal radiotherapy (45-50 Gy / (25f.5w), local recurrence of 18-20 Gy, (1.8-2.0) Gy / times, 5 times / week, the total dose of 63 ~ 70Gy〕, and simultaneous capecitabine chemotherapy (1 000 mg / m2, starting from the first day of radiotherapy, even for 14 days, rest 7d for a cycle, during radiotherapy Oral 2 cycles). After the end of radiotherapy with the program to consolidate the two cycles of chemotherapy. Results: Among the 33 patients, 5 were CR (15.2%), PR 20 (60.6%), NC 6 (18.2%) and PD 2 (6.1%) with a total effective rate of 75.8%. Serum CEA decreased 50% and maintained for 1 month in 21 cases (84.0%). After treatment, clinical symptoms improved and significantly improved in 29 cases (87.9%). The main adverse reactions are hematological toxicity, gastrointestinal reactions, acute cystitis and hand-foot syndrome, etc., can be tolerated. Conclusion: IMRT combined with capecitabine concurrent chemotherapy in the treatment of postoperative recurrence of rectal cancer patients with mild adverse reactions, the exact effect of the recent, it is worth further clinical application.