观察复发转移结直肠癌患者中局部放射治疗（简称放疗）的临床疗效。

回顾性分析2020年1月至2025年8月内蒙古医科大学附属医院收治的31例复发和转移性结直肠癌患者的临床资料，为多线治疗失败后挽救性局部放疗，以姑息减症、局部控制为主。放疗采用CT模拟机增强扫描定位，Pinnacle计划系统勾画靶区，靶区处方剂量根据不同病灶部位制定，处方剂量：24~62.5 Gy/10~30次，不同放疗方案根据分割方式计算生物有效剂量（BED，α/β=10），以提高剂量之间的可比性。放疗期间联合化疗和/或靶向、免疫治疗。放疗结束1个月后进行放疗靶病灶的局部疗效评价，随访综合治疗后的总生存期。放疗期间观察患者的不良反应，按照常用不良事件评价标准（CTCAE 5.0）进行不良反应分级。采用Kaplan-Meier法进行生存分析，并通过Log-rank检验比较不同组间生存差异。

全组31例患者，平均年龄61岁，中位随访时间7.4个月，截止随访结束23例死亡，8例存活。患者放疗结束后1个月的临床疗效为：部分缓解14例（45.16%），疾病稳定16例（51.61%），疾病进展1例（3.13%），患者的客观缓解率为45.2%，疾病控制率为96.8%。综合治疗后本组患者的中位总体生存率为7.2个月，1年总体生存率率为23%。在放疗结束时，有9例患者出现1~2级不良反应。

局部放疗对≥2线系统治疗失败后复发转移结直肠癌患者局部控制率高、安全性可耐受，可作为挽救性治疗选择。

To explore the clinical effect of local radiotherapy in patients with recurrent and metastatic colorectal cancer.

The clinical data of 31 patients with recurrent and metastatic colorectal cancer admitted to the Affiliated Hospital of Inner Mongolia Medical University from January 2020 to August 2025 were analyzed retrospectively. These patients received salvage local radiotherapy after multiple lines of treatment failure, with the main goals being palliative symptom relief and local control. Radiotherapy was performed with CT simulation machine enhance scanning for positioning. The target area was delineated using the Pinnacle planning system. The prescription dose of the target area was formulated according to different lesion sites, with the prescription dose of 24-62.5 Gy/10-30 fraction. Different radiotherapy schemes calculated the biologically effective dose (BED, α/β=10) according to the segmentation method, so as to improve the comparability between doses. Chemotherapy and/or targeted immunotherapy were combined during radiotherapy. The clinical efficacy of local lesions was evaluated one month after radiotherapy, and the overall survival time after comprehensive treatment was followed up. At the same time, the adverse reactions of patients were observed during radiotherapy, and the adverse reactions were graded according to the common adverse event evaluation standard (CTCAE 5.0). Kaplan-Meier method was used for survival analysis, and the survival differences between different groups were compared by Log-rank test.

Among the 31 patients in the entire group, the average age was 61 years old, and the median follow-up time was 7.4 months. Up to the end of follow-up, 23 patients died and 8 patients survived. One month after the end of radiotherapy, the clinical effects were: partial remission in 14 cases (45.16%), stable disease in 16 cases (51.61%), progressive disease in 1 case (3.13%), with an objective response rate of 45.2% and a disease control rate of 96.8%. After comprehensive treatment, the median overall survival was 7.2 months, and the one-year overall survival rate was 23%. At the end of radiotherapy, 9 patients had grade 1-2 adverse reactions.

Local radiotherapy has high local control rate and tolerable safety for patients with recurrent and metastatic colorectal cancer after failure of ≥2-line system treatment, and can be used as a salvage treatment option.