The Applied Study Of PEH Combined With Radiation On The Prevention Of Postoperative Recurrence For Advanced Cancer In The Lower Rectum.

Objective: To explore the applied value of preoperative endocavitaryhyperthermia(PEH) combined with radiation on the prevention ofpostoperative recurrence for advanced cancer in the lower rectum .Methods: 72 cases of advanced cancer in the lower rectum werenon-randomized concurrently divided into 3 groups, A group including30 cases were treated by PEH combined with radiation,B group including15 cases were treated only by preoperative radiotherapy,C groupincluding 27 cases were not treated by preoperative endocavitaryhyperthermia or preoperative radiotherapy. The symptoms and pathologicchanges of every case before treatment and after treatment were recorded. Thelocal recurrence rates were recorded too. Using the methods of TUNEL,we determined the apoptosis of tumor cells at therapy front and afteroperation, and consequently proceeded to statistics and analysis. Allcases were followed-up at least 12 months. Results: All the patientsunderwent curative resection successfully. The symptoms of each casein A group was obviously alleviated, that in B group was partlyalleviated, and that in B group was not alleviated. The pathologicchanges of every case in A group were more significant as compared withthat in B group. There was no pathologic change in C group. The apoptosisindexes at therapy front operation of A group(Aia1) was 8.72±1.51‰,and the apoptosis indexes at therapy after operation of A group(Aia2)was 49.85±6.28‰,Aia1 was obviously lower than Aia2 (P<0.01).Aib1was 8.75±0.98‰,Aib2 was 27.57±2.51‰,Aib1 was obviously lower thanAia2 (P<0.01).Aic1 was 9.27±1.35‰,Aic2 was 8.77±1.39‰,there wasno difference between Aic1 and Aic2 (P>0.05).Aia2 was more significantas compared with Aib2 and Aic2 (P<0.001). The local recurrence ratesin A group was 3.33 %(1/30),that in B group was 13.33%(2/15),andthat in C group was 33.33%(9/27). The local recurrence rates in Agroup and that in B group were lower than that in C group(P<0.05).The reserving anus rates in A group was 33.33% (10/30), that in B groupwas 26.47%(4/15), and that in C group was 3.70%(1/27). The reservinganus rates in A group and that in B group were more significantly ascompared with that in C group(P<0.05). Conclusion: PEH combined withradiation for advanced cancer in the lower rectum can obviously alleviatethe symptoms of the patients, accelerate the pathologic changes of tumor,accelerate the apoptosis of tumor cells, reduce the local recurrencerates, and increase the reserving anus rates. This is a rational,feasible, safe and effective method on the prevention of postoperativerecurrence for advanced cancer in the lower rectum.