Abstract
Objective To explore the application value of surgical operation combined with neoadjuvant chemoradiation therapy for rectal carcinoma in phase Ⅱ and Ⅲ and to evaluate the effect of surgical resection. Methods A retrospective analysis was performed from January 2012 to January 2017, including 70 cases of middle and lower rectal carcinoma in phase Ⅱ and Ⅲ in the First Affiliated Hospital of Hebei North University. Neoadjuvant concurrent chemoradiotherapy before operation was applied. Neoadjuvant radiotherapy: total dose 50 Gy, 2.0 Gy for once, 5 times per week, 5 weeks in total, the radiation field 5 wild for pelvic irradiation. Neoadjuvant chemotherapy: XELOX (oxaliplatin, capecitabine)/ FOLFOX (oxaliplatin, leucovorin, 5-fluorouracil) was used for synchronous chemotherapy. After radiotherapy, the patients received surgery in 6-8 weeks. All the operations were performed according to the total mesorectum excision (TME) specification. Results A total of 70 patients underwent neoadjuvant concurrent chemoradiotherapy. The adverse effect rate was 15.71% (11/70) of grade Ⅰ and 7.14% (5/70) of grade Ⅱ. No grade Ⅲ and Ⅳ adverse reactions occurred. The tumor stage of 94.29% (66/70) patients reduced. The TNM stage of the postoperation was decreased compared with that before neoadjuvant chemoradiotherapy (χ2= 7.846, P < 0.05). Tumor resection rate was 94.29% (66/70). Conclusion Surgical operation combined with neoadjuvant concurrent chemoradiotherapy before operation for middle and lower rectal carcinoma in phase Ⅱ and Ⅲ has a favorable efficacy and safety, which can alleviate the tumor staging and increase the eradication rate of tumors. Key words: Rectal neoplasms; Chemotherapy, adjuvant; Radiotherapy, adjuvant; Total mesorectal excision
Published Version
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