目的 观察卡培他滨联合放疗治疗局部进展期直肠癌的疗效.方法 选择我院2007年6月-2010年6月收治的局部进展期直肠癌患者共52例,按照治疗方法分为对照组25例和观察组27例;对照组采用单纯放疗,观察组采用卡培他滨联合放疗.观察两组总体有效率(ORR)、毒副作用、癌胚抗原(CEA)水平、无进展生存期(PFS)、1年及2年生存率等.结果 对照组ORR为16/25,观察组为24/27,差异有统计学意义(χ2=4.530,P=0.049);主要毒副作用为骨髓抑制和腹泻.两组治疗前、治疗后CEA水平比较,差异均无统计学意义(P＞0.05);对照组治疗前后、观察组治疗前后CEA水平比较,差异均有统计学意义(P＜0.05).对照组PFS为(20.4±1.1)个月,观察组为(27.0±1.4)个月,差异有统计学意义(t=3.795,P＜0.05);对照组1年生存率为25/25,观察组为27/27,差异无统计学意义(χ2=0.000,P＞0.05);对照组2年生存率为21/25,观察组为25/27,差异有统计学意义(χ2=0.939,P＞0.05).Person相关分析显示,CEA水平与PFS呈负相关(r=-0.329,P=0.017)、与OS无线性相关性(r=-0.185,P=0.189).结论 卡培他滨联合放疗治疗局部进展期直肠癌疗效优于单纯放疗,CEA水平可能为预测其疗效的一项指标.%Objective To evaluate the efficacy of capecitabine combined with radiotherapy on rectal cancer. Methods Fifty - two patients with locally advanced rectal cancers admitted from June 2007 to June 2010 were divided, according to treatment, into groups control ( n = 25 ), study ( n = 27 ). Control group given only radiotherapy, study group combined with capecitabine. The overall response rate ( ORR ), adverse reaction, carcinoembryonic antigen ( CEA ), progression - free survival ( PFS), 1 - , 2 -year survival rate were observed in 2 groups. Results ORR was 16/25 in control group, 24/27 in study group, the difference was significant ( x2=4. 530, P = 0. 049 ); The main adverse reactions were myelosuppression and diarrhea. No difference was noted in CEA level between 2 groups before or after treatment ( P > 0. 05 ), but there was between pre - and post - treatments in the two groups ( P < 0. 05 ). PFS was ( 20. 4 ± 1. 1 ) months in control group, ( 27. 0 ± 1. 4 ) months in study group, the difference was significant ( t = 3. 795, P < 0. 05 ). The 1 - year survival rate was 25/25 in control group, 27/27 in study group, the difference was not significant ( x2=0. 000, P >0. 05 ), the 2 -year survival rate was 21/25 in control group, 25/27 in study group, the difference was significant ( x2=0.939, P > 0. 05 ). By Person correlation analysis , CEA level was negatively correlated with PFS ( r = - 0. 329, P= 0. 017 ), not with OS ( r = - 0. 185 , P = 0. 189 ). Conclusion The effect of capecitabine combined with radiotherapy is superior to that of simple radiotherapy. CEA level can be one of the indicators predicting the effects of capecitabine with radiotherapy.
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