本文選題：直腸局部復(fù)發(fā)癌 + 治療方式��； 參考：《中國實(shí)用外科雜志》2017年09期

【摘要】：目的探討直腸前切除術(shù)后局部復(fù)發(fā)癌的精準(zhǔn)治療方式。方法回顧性分析遼寧省腫瘤醫(yī)院2008年2月至2014年9月收治的178例直腸前切除術(shù)后局部復(fù)發(fā)癌的臨床資料,分析不同治療方式與病人預(yù)后的關(guān)系。結(jié)果 178例病人的總生存期為(32.8±1.2)個月。根治性切除病人生存期優(yōu)于姑息性切除病人[(40.8±1.4)個月vs.(27.5±1.6)個月]。直接行根治性切除與放療后根治性切除病人生存期差異無統(tǒng)計學(xué)意義[(41.3±1.5)個月vs.(38.6±2.6)個月]。直接行姑息性切除和放療后姑息性切除及造口病人,三者之間生存期差異無統(tǒng)計學(xué)意義[(27.8±1.6)個月vs.(25.8±4.5)個月vs.(23.9±4.9)個月]。局部復(fù)發(fā)腫瘤直接姑息性切除病人的預(yù)后好于行放化療病人[(27.8±1.6)個月vs.(16.4±2.2)個月]。但放療后姑息性切除病人與行放化療病人的生存期差異無統(tǒng)計學(xué)意義。結(jié)論對于復(fù)發(fā)腫瘤應(yīng)爭取行根治性手術(shù)。如果腫瘤不可切除,應(yīng)通過放化療手段進(jìn)行轉(zhuǎn)化治療后,再行根治性手術(shù)。姑息性切除手術(shù)應(yīng)慎重選擇,特別對于復(fù)發(fā)腫瘤放療后仍不能達(dá)到根治性切除的病人,提示腫瘤的生物學(xué)行為不佳,治療應(yīng)以對癥為主。
[Abstract]:Objective to investigate the accurate treatment of local recurrent cancer after anterior rectal resection. Methods the clinical data of 178 patients with locally recurrent cancer after anterior rectal resection in Liaoning Cancer Hospital from February 2008 to September 2014 were retrospectively analyzed and the relationship between different treatment methods and the prognosis of patients was analyzed. Results the total survival time of 178 patients was 32.8 鹵1.2 months. The survival time of radical resection patients was better than that of palliative resection patients [40.8 鹵1.4 months vs.(27.5 鹵1.6 months]. There was no significant difference in survival between radical resection and radiotherapy [41.3 鹵1.5 months vs.(38.6 鹵2.6 months]. There was no significant difference in survival between patients undergoing palliative resection and postoperative palliative resection and operation after radiotherapy [27.8 鹵1.6 months, vs.(25.8 鹵4.5 months, vs.(23.9 鹵4.9 months]. The prognosis of patients with local recurrence tumor was better than that of patients undergoing radiotherapy and chemotherapy [27.8 鹵1.6 months vs.(16.4 鹵2.2 months]. However, there was no significant difference in survival between patients undergoing palliative resection and patients undergoing radiotherapy and chemotherapy. Conclusion radical operation should be performed for recurrent tumors. If the tumor is unresectable, radical surgery should be performed after chemotherapy and radiotherapy. Palliative resection should be carefully selected, especially for the patients who can not reach radical resection after radiotherapy, suggesting that the biological behavior of the tumor is not good, and the treatment should be mainly symptomatic.
【作者單位】： 中國醫(yī)科大學(xué)腫瘤醫(yī)院遼寧省腫瘤醫(yī)院結(jié)直腸外科;
【基金】：遼寧省科學(xué)事業(yè)公益研究基金(No.2016003002)
【分類號】：R735.37

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