CAJ | 학술논문

行直肠癌根治术的患者中,有4％～30％的患者发生局部复发.其检出与诊断,主要依靠原发肿瘤根治术后的随访、病史体检、肿瘤标志物和影像学检查.对于局部复发患者,过去以保守治疗为主,患者预后及生存质量普遍较差,手术再切除联合辅助放化疗及术前术中放疗是目前的主要治疗手段,术式选择根据复发部位、盆腔内侵犯情况而定.复发灶R0切除为手术目标,拥有相对较好的预后.对于曾接受过放疗的患者,局部复发后术前接受中等剂量的放疗是较安全的.对于不可切除的复发灶,姑息性切除以及姑息性放化疗是缓解症状改善生活质量可行的方法.
행직장암근치술적환자중,유4％～30％적환자발생국부복발.기검출여진단,주요의고원발종류근치술후적수방、병사체검、종류표지물화영상학검사.대우국부복발환자,과거이보수치료위주,환자예후급생존질량보편교차,수술재절제연합보조방화료급술전술중방료시목전적주요치료수단,술식선택근거복발부위、분강내침범정황이정.복발조R0절제위수술목표,옹유상대교호적예후.대우증접수과방료적환자,국부복발후술전접수중등제량적방료시교안전적.대우불가절제적복발조,고식성절제이급고식성방화료시완해증상개선생활질량가행적방법.
After receiving radical resection of primary rectal cancer,about 4％ to 30％ patients would occur local recurrence.Diagnosis of local recurrence relies on postoperative follow-up,physical examination,tumor markers and imageological examination.For the local recurrent patients,conservative therapeutic regimen had been popular in the past days with poor prognosis and quality of life.Nowadays multimodality treatment with radical resurgery combined with chemoradiotherapy and IORT has been taking the main part in the management of local recurrence.The choice of surgery depends on the site of recurrence and invasion situation inside the pelvic cavity.The aim of the radical reoperation is R0 resection because it leads to an optimistic prognosis.Previously irradiated patients are relatively safe after receiving median-dose reirradiation.For the cases whose recurrence are unavailable for radical resection,palliative operation and chemoradiotherapy may be the wise choice to relieve their symptoms and improve the quality of life.