Clinical Analysis Of Curative Effect Of Preoperative Radiochemotherapy Combined With TME Technique In Treatment ForⅡ/Ⅲ Stage Rectal Cancer

ObjectiveThrough analysing the clinical curative effect of preoperative radiochemotherapy combined with TME technique in treatment for Ⅱ/Ⅲ stage rectal cancer and summarizing clinical experience, we wish a better way to instruct us in clinical work and to improve the patients’prognosis and life quality.Methods112patients were collected and divided into two groups, who were hospitalized in Gastrointestinal Surgery Department of the First affiliated hospital of Zhengzhou University between January.2005and December,2010.56patients who received preoperative radiochemotherapy were divided into A group, the other patients who only received surgical treatment were divided into B group. We compared two groups in the aspects of the security of preoperative radiochemotherapy, tumor-downstaging, RO curative resection rate, anal preservation rate, local recurrence rate and long-term survival rate. Count data was calculated by Chi-square test or Fisher’Exact Test, and the survival data was analysed by Kaplan-Meier method and Log-rank test. The significant level is less than0.05. Results(1)In the progress of preoperative radiochemotherapy, we observed15patients white blood count descended, and perineal skin lesions happened in9patients.22patients feeled numb, and35patients showed manifestations of digestive system such as nausea, vomit, diarrhea, etc.(2) There were35patients in all showed tumor down-staging, with10patients complete clinical response and9patients complete pathological response.(3) There were significant difference between A and B in R0radical resection rate (91.1%vs75%)and anal preservation rate(64.7%vs26.3%), but not significant in anastomotic leakage rate (6.0%vs4.8%) and incision liquefaction rate (12.5%vs8.9%)(4)3-year local recurrence rate was8.9%in A group and26.8%in B group, A group was significantly lower than B group. But there were no significant difference in3-year survival rate (80.4%vs71.4%) and5-year survival rate (57.1%vs53.6%) between two groups.Conclusions(1) Preoperative radiotherapy combined with FOLFOX6is secure, and acute adverse effects rarely happen. In addition, it does not promote the anastomotic leakage rate and incision liquefaction rate.(2) Preoperative radiotherapy combined with FOLFOX6can make tumor stage down with partly CCR or PCR, reduce the CRM positive rate, and promote R0radical resection rate and anal preservation rate.(3) preoperative radiochemotherapy combined with TME technique can significantly reduce3-year local recurrence rate, but can not improve the long-term survival rate.