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\u5927\u8178\u764c\u6cbb\u7642\u57fa\u672c\u70ba\u624b\u8853\u5207\u9664\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u4e26\u7121\u91cd\u8981\u7684\u89d2\u8272\uff1b\u56e0\u70ba\u5728\u8179\u8154\u5167\u7684\u5927\u8178\u764c\u816b\u7624\u6703\u96a8\u8457\u8178\u9053\u8815\u52d5\u8b8a\u63db\u4f4d\u7f6e\uff0c\u653e\u5c04\u816b\u7624\u79d1\u91ab\u5e2b\u5f88\u96e3\u6e96\u78ba\u5730\u5c07\u653e\u5c04\u7dda\u6cbb\u7642\u7bc4\u570d\u9396\u5b9a\u5728\u75c5\u7076\u4e0a\uff0c\u800c\u4e14\u7121\u6cd5\u8eb2\u958b\u5145\u6eff\u8179\u8154\u5c0d\u653e\u5c04\u7dda\u8f03\u654f\u611f\u7684\u5c0f\u8178\u3002<\/p>\n
\u76f8\u8f03\u5927\u8178\u764c\uff0c\u76f4\u8178\u764c\u7684\u6cbb\u7642\u5247\u8907\u96dc\u5f97\u591a\u3002\u50b3\u7d71\u4e0a\u76f4\u8178\u764c\u5982\u672a\u767c\u751f\u8f49\u79fb\uff0c\u7b2c\u4e00\u7dda\u6cbb\u7642\u4ea6\u70ba\u624b\u8853\u5207\u9664\u3002\u4e2d\u9ad8\u4f4d\u76f4\u8178\u764c\u5982\u679c\u816b\u7624\u4e0d\u5927\u6642\uff0c\u53ef\u4ee5\u9806\u5229\u5207\u9664\u4e26\u76f4\u63a5\u8207\u8178\u9053\u63a5\u5408\u3002\u82e5\u816b\u7624\u904e\u5927\u3001\u4fb5\u72af\u7bc4\u570d\u904e\u5ee3\u3001\u75c5\u60a3\u904e\u65bc\u80a5\u80d6\u6216\u9aa8\u76c6\u8154\u592a\u7a84\u6642\uff0c\u5c0e\u81f4\u624b\u8853\u64cd\u4f5c\u4e0d\u6613\u800c\u7522\u751f\u5408\u4f75\u75c7\uff0c\u751a\u8005\u9084\u9700\u8981\u65bd\u884c\u4fdd\u8b77\u6027\u8ff4\u8178\u9020\u5ed4\u8853\u4f86\u9632\u6b62\u63a5\u5408\u8655\u6ef2\u6f0f\u3002<\/p>\n
\u800c\u4f4e\u4f4d\u76f4\u8178\u764c(\u96e2\u809b\u9580\u53e37-8\u516c\u5206\u4ee5\u5167)\u56e0\u70ba\u6280\u8853\u554f\u984c\uff0c\u9700\u4f5c\u8179\u90e8\u3001\u6703\u9670\u806f\u5408\u5207\u9664\u624b\u8853(abdominal-perineal resection)\uff0c\u624b\u8853\u6642\u5fc5\u9808\u5207\u9664\u809b\u9580\u62ec\u7d04\u808c\uff0c\u65bd\u884c\u6c38\u4e45\u6027\u4eba\u5de5\u809b\u9580\u3002\u56e0\u754f\u65bc\u4eba\u5de5\u809b\u9580\u7684\u7167\u8b77\u53ca\u9593\u63a5\u9020\u6210\u65e5\u5f8c\u751f\u6d3b\u7684\u4e0d\u4fbf\uff0c\u5e38\u8b93\u75c5\u60a3\u6050\u61fc\u800c\u4e0d\u9858\u63a5\u53d7\u624b\u8853\u3002<\/p>\n
\u70ba\u4e86\u907f\u514d\u4e0a\u8ff0\u72c0\u6cc1\uff0c\u8fd1\u4f86\u653e\u5c04\u7dda\u6cbb\u7642\u5728\u76f4\u8178\u764c\u7684\u89d2\u8272\u8207\u4ee5\u5f80\u6709\u5f88\u5927\u4e0d\u540c\u3002<\/p>\n
\u4e00\u3001\u8853\u524d\u540c\u6642\u6027\u5316\u7642\u8207\u653e\u5c04\u7dda\u6cbb\u7642(Neoadjuvant Concurrent Chemoradiotherapy)<\/p>\n
\u9069\u7528\u7bc4\u570d\u6709\u4e09\u7a2e\uff1a<\/p>\n
\u91ab\u5e2b\u6c7a\u5b9a\u6b64\u7a2e\u6cbb\u7642\u65b9\u5f0f\uff0c\u4e3b\u8981\u7684\u539f\u56e0\u662f\u7531\u65bc\u76f4\u8178\u8655\u65bc\u9aa8\u76c6\u8154\uff0c\u4f4d\u7f6e\u56fa\u5b9a\u4e0d\u52d5\u3002\u653e\u5c04\u7dda\u53ef\u4ee5\u76f4\u63a5\u7167\u5c04\u816b\u7624\uff0c\u5c07\u816b\u7624\u7e2e\u5c0f\uff0c\u5408\u4f75\u5316\u7642\u66f4\u53ef\u52a0\u5f37\u6548\u679c\u3002\u816b\u7624\u7e2e\u5c0f\u5f8c\u65b9\u4fbf\u5916\u79d1\u91ab\u5e2b\u624b\u8853\u5207\u9664\uff0c\u6e1b\u5c11\u8853\u4e2d\u4f75\u767c\u75c7\uff0c\u540c\u6642\u589e\u52a0\u809b\u9580\u4fdd\u7559\u6a5f\u6703\u3002\u6b64\u5916\uff0c\u63a5\u53d7\u7167\u5c04\u4e4b\u816b\u7624\u8207\u8178\u9053\u65bc\u8853\u4e2d\u88ab\u5207\u9664\uff0c\u4ee5\u5065\u5eb7\u4e4b\u8178\u9053\u505a\u63a5\u5408\uff0c\u53ef\u6e1b\u5c11\u653e\u7642\u526f\u4f5c\u7528\u8207\u665a\u671f\u4f75\u767c\u75c7\u3002<\/p>\n
\u6b64\u9805\u6280\u8853\u5c0d\u65bc\u4ee5\u524d\u5fc5\u9808\u63a5\u53d7\u8179\u90e8\u6703\u9670\u5207\u9664\u624b\u8853\u7684\u76f4\u8178\u764c\u60a3\u8005\uff0c\u4e5f\u63d0\u4f9b\u4e86\u53e6\u4e00\u500b\u53ef\u80fd\u4fdd\u7559\u809b\u9580\u529f\u80fd\u7684\u9078\u64c7\u6a5f\u6703\u3002\u5927\u5e45\u63d0\u5347\u75c5\u60a3\u63a5\u53d7\u624b\u8853\u7684\u610f\u9858\uff0c\u8fd1\u5e74\u4f86\u9010\u6f38\u70ba\u5168\u4e16\u754c\u6240\u63a1\u7528\u3002\u53f0\u7063\u8207\u7f8e\u570b\u5927\u90e8\u5206\u91ab\u5b78\u4e2d\u5fc3\u4e5f\u8a02\u70ba\u6cbb\u7642\u76f4\u8178\u764c\u6e96\u5247\u4e4b\u4e00\u3002\u6839\u64da\u9577\u671f\u8ffd\u8e64\u7814\u7a76\u5831\u544a\u986f\u793a\uff0c\u6b64\u9805\u6280\u8853\u80fd\u964d\u4f4e\u76f4\u8178\u764c\u624b\u8853\u5f8c\u5c40\u90e8\u518d\u767c\u7684\u6a5f\u7387\uff0c\u9054\u5230\u66f4\u4f73\u7684\u5c40\u90e8\u63a7\u5236\u6210\u6548\u3002<\/p>\n
\u5176\u7f3a\u9ede\u5728\u65bc\u653e\u3001\u5316\u7642\u9700\u9032\u884c\u7d046\u5468\uff0c\u7d50\u675f\u5f8c\u53c8\u9808\u7b496\u5468\u8b93\u816b\u7624\u8b8a\u5c0f\u624d\u80fd\u624b\u8853\u3002\u5f9e\u8a3a\u65b7\u81f3\u624b\u8853\u7d04\u9700\u89813\u500b\u6708\u6f2b\u9577\u7b49\u5f85\uff0c\u75c5\u60a3\u9700\u8981\u5805\u5f37\u7684\u5fc3\u7406\u652f\u6301\u3002\u53e6\u56e0\u624b\u8853\u524d\u7684\u653e\u5c04\u7834\u58de\uff0c\u53ef\u80fd\u4f7f\u9019\u4e9b\u7d44\u7e54\u5728\u958b\u5200\u5f8c\u75ca\u7652\u6642\u9593\u52a0\u9577\uff0c\u6545\u8853\u5f8c\u4fdd\u8b77\u6027\u5c0f\u8178\u9020\u53e3\u6bd4\u4f8b\u6703\u589e\u52a0\u3002<\/p>\n
\u5c0d\u65bc\u67d0\u90e8\u5206\u5e78\u904b\u4e4b\u75c5\u60a3(\u7d0420~25%)\uff0c\u540c\u6642\u6027\u653e\u3001\u5316\u7642\u53ef\u5c07\u816b\u7624\u7e2e\u5c0f\u81f3\u4e0d\u53ef\u898b\uff0c\u75c5\u60a3\u53ef\u4ee5\u9078\u64c7\u7d93\u809b\u9580\u5c07\u816b\u7624\u6b98\u8de1\u5207\u9664\u8b49\u5be6\u816b\u7624\u6d88\u5931\u6216\u89c0\u5bdf\u7b49\u5f85\uff0c\u5f85\u816b\u7624\u6709\u5fa9\u767c\u8de1\u8c61\u6642\u624d\u63a5\u53d7\u6839\u9664\u6027\u624b\u8853\u3002<\/p>\n
\u53e6\u5916\u5c0d\u65bc\u8eab\u9ad4\u72c0\u6cc1\u4e0d\u826f\uff0c\u591a\u91cd\u5171\u75c5\u7121\u6cd5\u627f\u53d7\u6839\u9664\u6027\u624b\u8853\u7684\u75c5\u60a3\uff0c\u6b64\u9805\u6cbb\u7642\u65b9\u5f0f\u4ea6\u6709\u53ef\u80fd\u5c07\u816b\u7624\u7e2e\u5c0f\u81f3\u53ef\u7d93\u809b\u9580\u5c07\u816b\u7624\u5207\u9664\u3002\u5728\u9019\u7a2e\u60c5\u6cc1\u4e0b\uff0c\u53ef\u9054\u5c40\u90e8\u816b\u7624\u63a7\u5236\uff0c\u5ef6\u9577\u58fd\u547d\u4e4b\u76ee\u6a19\u3002<\/p>\n
\u4e8c\u3001\u8853\u5f8c\u8f14\u52a9\u6027\u5316\u7642\u8207\u653e\u5c04\u7dda\u6cbb\u7642 (Adjuvent Concurrent chemoradiotherapy)<\/p>\n
\u5c0d\u65bc\u8853\u524d\u672a\u505a\u8f14\u52a9\u6027\u653e\u5c04\u7dda\u6cbb\u7642\u4e4b\u75c5\u60a3\uff0c\u9700\u4f9d\u75c5\u7406\u671f\u5225\uff08\u7b2c\u4e09\u671f\uff09\u53ca\u5371\u96aa\u56e0\u5b50\u7d66\u4e88\u8853\u5f8c\u7684\u5316\u7642\u8207\u653e\u5c04\u7dda\u6cbb\u7642\u3002\u4f8b\u5982\u8853\u5f8c\u816b\u7624\u5df2\u4fb5\u72af\u5176\u4ed6\u5668\u5b98(T4)\uff0c\u624b\u8853\u908a\u7de3\u6709\u816b\u7624\u6b98\u5b58(margin involved)\uff0c\u6216\u6709\u6dcb\u5df4\u8f49\u79fb\u7b49\uff0c\u9032\u4e00\u6b65\u8f14\u52a9\u6027\u5316\u653e\u7642\u53ef\u6e1b\u5c11\u5c40\u90e8\u5fa9\u767c\u3002<\/p>\n
\u6b64\u6642\u653e\u5c04\u7dda\u6cbb\u7642\u901a\u5e38\u5728\u958b\u5200\u5f8c\u50b7\u53e3\u75ca\u7652\u5f8c\u958b\u59cb\u3002\u7bc4\u570d\u901a\u5e38\u5305\u62ec\u4e86\u6574\u500b\u9aa8\u76c6\u8154\uff0c\u6db5\u84cb\u816b\u7624\u65c1\u672a\u5207\u9664\u7684\u90e8\u5206\uff08\u4ee5\u675c\u7d55\u5fae\u89c0\u4e0b\u672a\u88ab\u5207\u9664\u7684\u764c\u7d30\u80de\u5fa9\u767c\uff09\u3002\u65bc\u662f\uff0c\u8853\u5f8c\u7684\u653e\u5c04\u7dda\u6cbb\u7642\u7bc4\u570d\u5c31\u6bd4\u8853\u524d\u6cbb\u7642\u7bc4\u570d\u5927\u3002\u800c\u4e14\u7167\u5c04\u90e8\u4f4d\u7686\u70ba\u76f8\u5c0d\u5065\u5eb7\u7684\u7d44\u7e54\uff0c\u526f\u4f5c\u7528\u8207\u665a\u671f\u4f75\u767c\u75c7\u7686\u6bd4\u8853\u524d\u6cbb\u7642\u56b4\u91cd\u3002\u75c5\u60a3\u4e5f\u53ef\u80fd\u56e0\u8853\u5f8c\u9ad4\u529b\u672a\u6062\u5fa9\u800c\u7121\u6cd5\u5b8c\u6210\u6cbb\u7642\u3002<\/p>\n
\u7531\u65bc\u6709\u4e9b\u7f3a\u9ede\uff0c\u76ee\u524d\u5927\u90e8\u5206\u91ab\u5e2b\u7686\u50be\u5411\u8853\u524d\u540c\u6642\u6027\u5316\u7642\u8207\u653e\u5c04\u7dda\u6cbb\u7642\uff0c\u653e\u5c04\u5291\u91cf\u53ef\u4ee5\u8f03\u5c11\u3001\u7167\u5c04\u7bc4\u570d\u4e5f\u53ef\u5c0f\u4e00\u9ede\uff0c\u9084\u80fd\u5920\u8a66\u8457\u4fdd\u5b58\u809b\u9580\u3002<\/p>\n
\u4e09\u3001\u59d1\u606f\u6027\u653e\u5c04\u7dda\u6cbb\u7642 (Palliative radiotherapy)<\/p>\n
\u548c\u8a31\u591a\u5176\u4ed6\u7684\u764c\u75c7\u4e00\u6a23\uff0c\u76f4\u8178\u764c\u4e00\u65e6\u8a3a\u65b7\u6642\u5df2\u767c\u73fe\u9060\u7aef\u8f49\u79fb\u7121\u6cd5\u6839\u9664\u6642\uff0c\u5168\u8eab\u6027\u5316\u7642\u662f\u4e00\u500b\u597d\u9078\u64c7\uff0c\u539f\u767c\u816b\u7624\u4e0d\u4e00\u5b9a\u9700\u8981\u5207\u9664\u3002\u4f46\u6cbb\u7642\u671f\u9593\u53ef\u80fd\u56e0\u816b\u7624\u9020\u6210\u8178\u9053\u963b\u585e\uff0c\u88e1\u6025\u5f8c\u91cd\uff0c\u983b\u7e41\u8840\u4fbf\uff0c\u751a\u81f3\u75bc\u75db\u3002\u6b64\u6642\u653e\u5c04\u7dda\u6cbb\u7642\u53ef\u7528\u4f86\u6e1b\u5c0f\u816b\u7624\u9ad4\u7a4d\uff0c\u7de9\u89e3\u816b\u7624\u6240\u5f15\u8d77\u7684\u5c40\u90e8\u75bc\u75db\u6216\u51fa\u8840\u7b49\u73fe\u8c61\uff0c\u4ee5\u63d0\u5347\u751f\u6d3b\u54c1\u8cea\u3002<\/p>\n
\u76f4\u8178\u764c\u6cbb\u7642\u591a\u8b8a\uff0c\u75c5\u60a3\u5e38\u56e0\u8907\u96dc\u7684\u8655\u7f6e\u8207\u6642\u9593\u7b49\u5f85\u800c\u9020\u6210\u8aa4\u6703\u3002\u91ab\u5e2b\u8207\u75c5\u60a3\u7686\u9808\u4e92\u76f8\u8a0e\u8ad6\u914d\u5408\uff0c\u4ee5\u9054\u6210\u6700\u5408\u9069\u7684\u75be\u75c5\u63a7\u5236\u8207\u6cbb\u7642\u3002<\/p>\n","protected":false},"excerpt":{"rendered":"
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