Clinical Analysis Of The Neoadjuvant Chemotherapy Efficacy In Middle-low Advanced Colorectal Cancer

Objective：By calculating the tumor size, tumor margin under distance from theanal verge, MRI-TNM staging, Sphincter preservation after neoadjuvantchemotherapy，combined with the pathological situation to analyze theclinical efficacy of neoadjuvant chemotherapy in middle-low advancedcolorectal cancerMaterials and methods:We Collected the36patients with middle-low advanced colorectalcancer who underwent neoadjuvant chemoradiotherapy and totalmesorectal excision (TME) from July2010to July2013in my hospitalColorectal&Anal Surgery，and retrospective analysis of36cases，Inclusion criteria:(1) preoperative colonoscopy see the lower edgeof the tumor from the anal verge distance10cm below the remainingintestine no tumor.(2) All cases by colonoscopy, living tissue biopsy, thediagnosis of adenocarcinoma.(3) preoperative clinical staging of pelvicMRI prompt compliance with T3or T4stage, abdominal CT and chest CT,bone scintigraphy when necessary (ECT) confirm that no liver, lungs,bone and other distant organ metastasis.Then sync all patients underwent neoadjuvant chemotherapy,radiotherapy solutions for low-dose long course of radiotherapy: pelvicradiation field that is added after local tumor irradiation, the total dose of36-50Gy, day12Gy, five days a week continuous exposure, rest2days ofirradiation18-25times, when it takes about five weeks. Chemotherapy:radiation from the first day, synchronous oral capecitabine tablets basedchemotherapy. After neoadjuvant chemoradiotherapy, preoperative pelvic MRI in patients with colorectal cancer re-examination, a clear change inlocal tumor (T) and changes in the surrounding lymph nodes (N), todetermine the clinical stage again.Neoadjuvant chemotherapy ends, rest6-8weeks after patients,admitted between the relevant checks, no clear contraindications aftersurgery, according to the principle of total mesorectal excision (TEM)underwent radical resection, postoperative pathological specimens by allhospital after the row corresponding pathologist pathology treatment, toBy calculating the tumor size, tumor margin under distance from the analverge, MRI-TNM staging, Sphincter preservation after neoadjuvantchemotherapy，combined with the pathological situation to analyze theclinical efficacy of neoadjuvant chemotherapy in middle-low advancedcolorectal cancer.。Results:1after neoadjuvant chemotherapy，Cancers shrank from a meandiameter of4.90cm to2.64cm,down size rate was46.1%。2by DukeS staging,24patients got down-staging, lowering of therate of67%. Clinical cases of complete remission in9patients,6patientsachieved pathological complete response (pCR), the remission rate was25%and16.7%, respectively.3.26received neoadjuvant chemotherapy before undergoingabdominal perineal colorectal cancer proposed resection (Miles’),treatment underwent sphincter preserving surgery in10patients (8caseswhere surgery Dixon, Parks surgery one case, one case of colorectalcancer prolapse surgery) Conclusion:Neoadjuvant chemotherapy can reduce tumor volume, reduce tumorstaging. improve sphincter preservation...