Preoperative Radiotherapy for colorectal Cancer
Preoperative Radiotherapy for colorectal Cancer
复制标题
结直肠癌术前放疗
DOI：
10.1001/jama.1976.03270110017009
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发表时间：
1975
影响因子：
9
通讯作者：
R. Keehn
中科院分区：
文献类型：
--
作者：
G. Higgins;J. Conn;P. H. Jordan;E. Humphrey;B. Roswit;R. Keehn
在一项前瞻性随机试验中，700例确诊为直肠或直肠乙状结肠腺癌的患者随机接受术前放疗（两周内2000至2500拉德）或单纯手术。X线治疗组453例患者的5年生存率为48.5%，对照组为38.8%，而在305例需要腹会阴切除术的低位病变中，治疗组的生存率为46.9%，对照组为34.3%。尽管提示治疗获益，但认为两者均不具有统计学显著性。在对照组中发现41.2%的组织学阳性淋巴结，而在接受放射治疗的患者中仅为27.8%。对研究期间死亡的所有患者的回顾显示，放射治疗组的癌症死亡率始终较低。虽然这项研究表明术前放疗对治疗有好处，但目前还需要该组和其他研究人员进行进一步研究，以确定最佳剂量方案。
In a prospective randomized trial, 700 patients with a confirmed histological diagnosis of adenocarcinoma of the rectum or rectosigmoid were randomized to receive radiotherapy prior to operation (2000 to 2500 rads in two weeks) or surgery alone. Five year observed survival in the 453 patients on whom "curative" resection was possible was 48.5% in the X-ray treated group compared with 38.8% in controls, while in the 305 having low lying lesions requiring abdominoperineal resection, survival in the treated group was 46.9% compared with 34.3% in controls. Although suggestive of a treatment benefit, neither is considered statistically significant. Histologically positive lymph nodes were found in 41.2% of the control group and in only 27.8% of the patients receiving radiotherapy. Reveiw of all patients who died during the study shows a consistently lower death rate from cancer in the radiotherapy group. Although this study suggests a treatment benefit from preoperative radiotherapy, further studies now in progress by this group and others are necessary to determine the optimal dose regimen.