目的:分析局部侵犯性直腸癌病人接受術前同步化學及放射線治療，對腫瘤期別下降和肛門保留的幫助。

材料與方法:在1999年6月到2002年2月間，本院共有22名宜腸癌病人接受術前同步化學及放射線治療，再行手術切除。其中包括16位男性和6位女性，年齡分佈從28到76歲，年齡中位數61歲。化學治療使用高劑量子Fluorouracil(5-FU)合併Leucovorin放射治療中位劑量為 50AGy (45Gy - 50AGy)針對骨益腔。放射治療結束後平均6週( I至11.7週)接受治癒性手 術。比較于術後病理期別和治療前臨床期別之間的差異，及肛門保留在這些病人的比例。

結果:22位病人中有12位(55% )有期別下降，其中有三位(14%)得到完全緩解，在切下組織標本中沒有殘存的腫瘤細胞。另外5位則是病理期別和臨床期別一樣。還有兩位則是治療前評估�NI'但病理期別顯示N2。有18位(82%)病人施行肛門保留性手術。

結論:術前同步化學及放射線治療再加上手術能有效使腫瘤期別下降，並能使大部分局部晚期宜腸癌病人保留肛門。

Purpose:This study is to present the rates of tumor down-staging and sphincter-preservation with pre-operative concurrent chemo-radiation therapy (CCRT) in locally advanced rectal cancer.

Methods and Materials : Between June1999 and February 2002， twenty-two patients with advanced rectal cancer were treated with preoperative CCRT， followed by surgical resection of disease， The patient population consisted of 16 males and 6 females that had a median age of 61 years (range 28 to 76 years)， Most of p叫ients received high dose 5-Fluorouracil (5-FU) and Leucovorin， concurrent with pelvic irradiation 50AOGy(45-50A Gy) in 28 fractions 0州'er 5，5 weeks， The median interval between completion of radiotherapy and surgery was 6 weeks (range 1- 11，7 weeks)， The pre-treatment and post-treatment stages were compared and rates of sphincter preservation were evaluated，

Results:Twel閱(55%) out of 22 patients achieved tumor downstaging， and 3 (14%) patients had pathologic complete remission， Five patients remained the same stage as pretreatment clinical stage， Two patients had clinical N1 disease but pathologic N2 stage Sphincter- preserving surgery can achieve in 18(82%) patients，

Conclusion: Pre-operative CCRT followed by surgery can be effective for tumor shrinkage， tumor downstaging， and achieving sphincter preservation in most of patients.