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《Chinese Journal of Clinical Oncology and Rehabilitation》 2012-01
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Clinical effect of preoperative chemoradiotherapy on the treatment of mid and low rectal cancer

WAN Xiang-bin,LI Zi,YUAN Long,et al(Department of General Surgery,Affilited Hospital of Zhengzhou University,Zhengzhou 450008,China)  
Objective To evaluated the effects of preoperative chemoradiotherapy on the mid and low rectal cancer.Methods sixty cases of mid and low rectal cancers(TNM stage Ⅲ and Ⅳ) that examined preoperatively by nuclear magnetic resonance imaging(MR) were enrolled in this study and divided randomly into the control group and the treatment group.Thirty cases of control group were operated directly without preoperation chemoraditherapy.The other 30 cases of treatment group were firstly treated twice with preoperative radiotherapy(40-45 Gy) combined with chemotherapy(oxaliplatin combined with Xeloda,XELOX) and were operated 4 to 5weeks later.All 60 cases were treated with chemotherapy(XELOX) after operation.The pathologic changes,expression of vascular endothelial growth factor(VEGF) and endothelial growth factor(EGF),complications and follow up results of these two group were compared.Results The VEGF and EGF reduced and its T stage degrade in the treatment group compared with those in the control group.The resection rate(93.3%vs 73.3%,) and the sphincter preserving rate(70.0%vs43.3%) increased in the treatment group compared with those in the control group.There were significant difference(P0.05).The positive expression rate of VEGF and EGF were decreased apparently in the treatment group(33.3% vs 60.0%,36.7% vs 63.3%).There was not significant difference in the incidence of postoperative complications between the 2 groups.The 3-year local recurrence rate has significant difference between the 2 groups(13.3%vs 36.7%).Conclusions Preoperative chemoradiotherapy can change the positive expression rate of VEGF and EGF,reducing local infiltration and metastasis in the mid and low rectal cancer(TNM stage Ⅲ and IV) without increasing the difficulty of operation and the incidence of postoperative complications.
【CateGory Index】: R735.37
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