摘要目的 观察氟尿嘧啶栓联合放疗治疗老年局部晚期不可手术直肠癌的疗效和不良反应.方法 46例经病理证实的老年局部晚期不可手术的直肠癌患者接受氟尿嘧啶栓塞肛,200 mg/粒,2次/d,连用10 d.24 d为一周期,共用2个周期.同期接受盆腔三维适形放疗,46～50 Gy/23～25F,后缩野至肿瘤区继续推量至64～66 Gy/32～33F,如有残留病灶则行腔内放疗15～20 Gy.结果 CR 18例(39.1%),PR 23例(50.0%),SD5例(10.9%),总有效率(CR+PR)89.1%,中位生存时间21.6个月,1、2年生存率分别为87.4%、71.9%.治疗相关毒副作用主要是腹泻和中性粒细胞减少,经对症处理患者均能耐受.结论 氟尿嘧啶栓联合放疗治疗老年局部晚期不可手术的直肠癌安全、有效,值得临床进一步研究.

abstractsObjective To observe the effect and toxicity of fluorouracil suppository and concurrent radiotherapy in elderly local advanced rectal cancer.Methods Forty-six elderly patients with ocal advanced rectal cancer were treated with 200 mg fluorouracil suppository by rectum,twice a day,for 10 days,a 24-dat cases of treatment,two cases of the treatment and combination with three dimensional-conformal radiotherapy( for46 ～50 Gy/23 ～25F and was boosted to the tumor 16 ～18Gy/2 weeks,2Gy/fraction,5 days/week).Intra-rectal cavity radiotherapy with 15 ～ 20 Gy for the residual lesion.Results The overall response rate was 89.1%,with CR 18 cases(39.1%),PR 23cases(50.0%),SD 5 cases(10.9%).Median survival time,the 1 、2a survival rate were 21.6 months,87.4% 、71.9% respectively Treatment-related toxicity mainly showed at diarrhea and neutrocytopenia.Conclusion Fluorouracil suppository and concurrent radiotherapy in elderly local advanced rectal cancer is safty,effective and valuable clincial study.