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[目的]探讨三维适形放射治疗同步化疗联合热疗治疗局部晚期及术后复发直肠癌的临床疗效及耐受性。[方法]将45例接受同步放化疗的局部晚期及术后复发直肠癌患者随机分为两组:观察组22例、对照组23例,两组的放化疗方法一致:化疗采用卡培他滨口服1250mg/(m2.d),分为两次口服,d1～14,休息7d后重复下一治疗周期。放疗采用6MVX线照射,总剂量DT60～66Gy/1.8～2Gy/次/d,5次/周。观察组采用放化疗联合热疗,热疗每周两次,每次60min,每次间隔72h,共进行6～8次,在放疗前后1h内进行。对照组单纯采用同步放化疗。比较2组的近期疗效、疼痛缓解及毒副反应情况。[结果]观察组疼痛缓解率90.9,对照组65.2,两组疼痛缓解率比较差异有统计学意义(P﹥0.05),2组近期有效率、毒副反应差异无统计学意义(P﹥0.05)。[结论]热疗联合三维适形放射治疗同步化疗能提高局部晚期及术后复发直肠癌患者的生活质量,且不增加毒副反应,是安全有效的治疗方案。
[Objective] To investigate the clinical efficacy and tolerability of three-dimensional conformal radiotherapy combined with concurrent chemotherapy and hyperthermia in the treatment of locally advanced and postoperative recurrent rectal cancer. [Methods] 45 patients with locally advanced and postoperative recurrent rectal cancer undergoing simultaneous radiotherapy and chemotherapy were randomly divided into two groups: 22 in the observation group and 23 in the control group. The radiotherapy and chemotherapy were the same in both groups: capecitabine was used for chemotherapy. Oral 1250mg / (m2.d), divided into two oral, d1 ~ 14, after 7d rest after the next treatment cycle. Radiotherapy was performed with 6MV X-rays, and the total dose was DT60-66Gy/1.8-2Gy/times/d, 5 times per week. The observation group was treated with radiotherapy and chemotherapy combined with hyperthermia. Hyperthermia was performed twice a week for 60 minutes, 72 hours each time, for a total of 6 to 8 sessions, and within 1 hour before and after radiotherapy. The control group was treated with concurrent radiotherapy and chemotherapy alone. The short-term efficacy, pain relief, and toxicity were compared between the two groups. [Results] The pain relief rate was 90.9 in the observation group and 65.2 in the control group. There was a statistically significant difference in the pain relief rate between the two groups (P>0.05). There was no significant difference in the efficiency and toxicities between the two groups (P>0.05). . [Conclusion] The combination of hyperthermia therapy and three-dimensional conformal radiation therapy can improve the quality of life of patients with locally advanced and postoperative recurrent rectal cancer, and does not increase toxic side effects. It is a safe and effective treatment plan.