目的：為研究本院結腸直腸癌病人手術後接受輔助性治療結果與其影響預後因子分析。材料與方法：自1996年至2003年共回溯性收集80例手術後結腸直腸癌病人，接受完整輔助性治療者，排除6例原發於骨盆腔外之結腸癌及一例非腺癌，另一例治療後即未回診；總共72例，男性50例，女性22例；年齡自29歲至79歲，平均56.4歲（中值60歲），其追蹤期自2-106個月（中值33個月）。病人之追蹤定期作理學檢查、放射線檢查、腹部超音波、大腸鏡檢查與腫瘤標幟。疾病分期依AJCC（第六版）分期，以四百萬或六百萬伏特高能直線加速器治療，放射劑量自45 Gy至61.2 Gy，每次照射給予劑量為1.8-2.0 Gy。治療方式採前後相對照野或箱形照野，有或無追加薦骨前區照射，化學治療以5FU為基本組合。結果：總共72例病人，其三年及五年存活率分別為68%與53%，中值存活期為33個月；其三年復發率為15%、五年為17%，臨床上腫瘤有侵襲血管、淋巴管滲透、神經旁侵犯等影響病人之生存期，尤其侵襲多處者預後差(P=0.001)，治療前之CEA值大於20 ng/ml也是預後因子。年齡≤50歲者與年長者預後並無差別。結論：骨盆腔範圍內之結腸直腸癌手術後加上輔助性治療結果良好。外科手術切除標本如有腫瘤侵襲血管、淋巴管滲透、神經旁侵犯可作為需要輔助性治療之參考，且影響病人生存期，年齡似非不良預後因子。

Purpose: To analyze the treatment result of colorectal cancer post-operative adjuvant chemotherapy and radiotherapy and to evaluate the prognostic factors. Materials and Methods: This is a retrospective study of eighty patients who underwent surgery for colorectal cancer and received post- operative adjuvant chemo-radiotherapy between January 1996 and December 2003. Tumor work-up and follow-up were documented by physical examination, image studies (CT, MRI, sonography), colonoscopy and CEA. The applied TNM staging system was based on the AJCC manual of staging of cancer 6th edition, 2002. The adjuvant radiation was delivered with linear accelerator and the radiation dosage ranged from 45 Gy to 61.2 Gy. The adjuvant chemotherapy was given with 5-FU based regimen. The STATA(superscript TM) computer database and SPSS were used for statistic analysis. Result: Of these 72 patients, the mean age was 56.4 years (median 60), the 3- and 5- year overall survival rates were 68 % and 53%, respectively; local control rates were 85% and 83%, respectively; the disease free survival rates were 47% and 41%, respectively. There were 18 patients under age 50 and 54 patients older than age 50. The survival rate for the younger was worse than the older in our study, but without statistic significance (p=0.2618). The resection specimen with blood vessel or lymphovascular permeation, inadequate margin and adjacent organs invasion resulted in a poor prognosis. The pretreatment CEA level more than 20 ng/ml was a significant risk factor for survival after stage was adjusted but not significant for local control or disease control. Conclusion: For colorectal cancer receiving surgery and post -operative chemotherapy and radiotherapy, the pathologic finding of lymphovascular permeation, blood vessel invasion and unclear margin are of prognostic significance. The pretreatment CEA level more than 20 ng/ml was also a risk factor.