CAJ | 학술논문

目的：比较奥沙利铂联合3 DCRT与单用3 DCRT、奥沙利铂应用于晚期直肠癌患者的近期疗效。方法选择72例晚期直肠癌患者，按随机数字表法分为观察组36例和对照组36例（对照组再均分为对照组 A和对照组B，每组18例）。对照组 A采用单纯3 DCRT方法，对照组 B采用单纯奥沙利铂治疗，观察组采用奥沙利铂联合3 DCRT方法。对3组患者放疗后的近期疗效、1年生存率、2年生存率、及不良反应（骨髓抑制反应、胃肠道反应、神经毒性及放射性直肠炎）发生率进行比较。结果观察组总有效率为94．4％，对照组 A总有效率为72．2％，对照组B总有效率为66．7％，观察组的总有效率明显优于对照组 A和对照组B（均P＜0．05）；对照组 A与对照组 B总有效率比较，差异无统计学意义（P＞0．05）。观察组的1年生存率（88．9％）和2年生存率（72．2％）均明显高于对照组 A（66．7％、38．9％）和对照组B（61．1％、38．9％）（均P＜0．05）；对照组 A与对照组 B 2组患者的生存率相比较，差异无统计学意义（P＞0．05）。观察组患者发生的不良反应中骨髓抑制反应、胃肠道反应及神经毒性，比对照组A明显（P＜0．05），但在放射性直肠炎方面，2组比较差异无统计学意义（P＞0．05）；观察组患者发生的不良反应中骨髓抑制反应、胃肠道反应及神经毒性，与对照组 B相比，差异无统计学意义（P＞0．05），在放射性直肠炎方面，2组患者比较差异有统计学意义（P＜0．05）。结论奥沙利铂联合3 DCRT治疗晚期直肠癌患者可提高放疗疗效，在改善临床症状、提高生活质量等方面有较好的临床效果。
목적：비교오사리박연합3 DCRT여단용3 DCRT、오사리박응용우만기직장암환자적근기료효。방법선택72례만기직장암환자，안수궤수자표법분위관찰조36례화대조조36례（대조조재균분위대조조 A화대조조B，매조18례）。대조조 A채용단순3 DCRT방법，대조조 B채용단순오사리박치료，관찰조채용오사리박연합3 DCRT방법。대3조환자방료후적근기료효、1년생존솔、2년생존솔、급불량반응（골수억제반응、위장도반응、신경독성급방사성직장염）발생솔진행비교。결과관찰조총유효솔위94．4％，대조조 A총유효솔위72．2％，대조조B총유효솔위66．7％，관찰조적총유효솔명현우우대조조 A화대조조B（균P＜0．05）；대조조 A여대조조 B총유효솔비교，차이무통계학의의（P＞0．05）。관찰조적1년생존솔（88．9％）화2년생존솔（72．2％）균명현고우대조조 A（66．7％、38．9％）화대조조B（61．1％、38．9％）（균P＜0．05）；대조조 A여대조조 B 2조환자적생존솔상비교，차이무통계학의의（P＞0．05）。관찰조환자발생적불량반응중골수억제반응、위장도반응급신경독성，비대조조A명현（P＜0．05），단재방사성직장염방면，2조비교차이무통계학의의（P＞0．05）；관찰조환자발생적불량반응중골수억제반응、위장도반응급신경독성，여대조조 B상비，차이무통계학의의（P＞0．05），재방사성직장염방면，2조환자비교차이유통계학의의（P＜0．05）。결론오사리박연합3 DCRT치료만기직장암환자가제고방료료효，재개선림상증상、제고생활질량등방면유교호적림상효과。
Objective To compare the short-term effects of oxaliplatin,three-dimensional con-formal radiation therapy(3DCRT)and their combination on advanced rectal cancer.Methods To-tally 72 patients with advanced rectal cancer were randomly treated with 3DCRT(control group A,n=18),oxaliplatin(control group B,n=18)or their combination(observation group,n=36). The short-term effect,1-year survival rate,2-year survival rate,and incidence of adverse reactions (bone marrow suppression,gastrointestinal reaction,neurotoxicity and radiation proctitis)were compared among the three groups.Results The total effective rate in observation group(94.4%) was significantly higher than that in control group A(72.2%)and control group B(66.7%)(P<0.05),but the difference was not significant between control group A and control group B(P>0.05).The 1-year survival rate and 2-year survival rate in observation group(88.9% and 72.2%, respectively)were significantly higher than those in control group A(66.7% and 38.9%,respec-tively)and control group B(61.1% and 38.9%,respectively)(P<0.05),but the differences were not significant between control group A and control group B(P>0.05).The incidences of bone marrow suppression,gastrointestinal reaction and neurotoxicity in observation group were signifi-cantly higher than those in control group A(P<0.05),but the difference in the incidence of radia-tion proctitis was not significant between the two groups (P>0.05 ).There was a significant difference in the incidence of radiation proctitis between observation group and control group B(P<0.05),but the differences in the incidences of bone marrow suppression,gastrointestinal reac-tion and neurotoxicity were not significant between the two groups(P>0.05).Conclusion Oxali-platin combined with 3DCRT can improve radiotherapy efficacy,clinical symptom and quality of life in patients with advanced rectal cancer.