The Effect Of PRAC Combined With Radiation On The Postoperate Recurrence And The Apoptosis Of Tumor Cell In Low Rectal Carcinoma

Objective : To explore the preoperative regional intra-arteral chemotherapy(PRAC) in neoadjuvant therapy for low rectal carcinoma.Methods: 61 cases of low rectal carcinoma were randomined into 3 groups, A group( 19cases, PRAC combined with radiation) , B group(15 cases, preoperative radiotherapy), C group (27 cases,without PRAC or preoperative radiotherapy).Using the methods of TUNEL ,we determine the apoptosis of tumor cells at therapy front and after operation,and consequently proceeds to statitics and analysis.All cases were followed-up at least 18 months.Results: All the patients underwent curative resection successfully. The apoptosis indexes(AI) at therapy front in Agroup (Alal) was 8.67 ± 1.01 ‰,obviously lower than that after operation (AIa2,53.89±5.17‰) (p<0.01). AIb1(8.75±0.98‰) obviouslylower than AIb2(27.57±2.51‰) (p<0.01).There was no difference between AIc1(9.27±1.35‰)and AIc2(8.77±1.39‰) (p>0.01). AIa2 was more significantly as compared with AIb2 and AIc2(p<0.001).The local recurrence rates in A groups was 5.26‰ (1/19) , in B group was 13.33‰(2/15)., obviously lower than in Cgroup(33.33‰,9/27) (p<0.05). The reserving anus rates in A groups was 31.58‰(6/19), in B group was 26.67‰ (4/15), more significantly as compared with that in C group(3.70‰,1/27) (p<0.05).Conclusions: PRAC combined with radiation in Low rectal carcinoma can accelerate the apoptosis of tumor cells, reduce the local recurrence rates, and increase the reserving anus rates. As neoadjuvant therapy is rational, feasible, safe and effective for improving of the therapeutic results in low rectal carcinoma.