局部晚期直肠癌术前调强放疗同步化疗的疗效评价及预后因素分析

局部晚期直肠癌术前调强放疗同步化疗的疗效评价及预后因素
分析
阿衣古丽·哈热;再依努尔·阿不都外力;张瑾熔;伊斯刊达·阿不力米提
【期刊名称】《现代肿瘤医学》
【年(卷),期】2017(025)010
【摘要】Objective:To observe the clinopathologic efficiency of preoperative intensity modulated radiation therapy(IMRT) with the concurrent chemotherapy in locally advanced rectal cancer
patients.Methods:A retrospective analysis was performed of the data of 60 patients with locally advanced rectal cancer underwent preoperative chemoradiation followed by radical resection from January 2010 to July 2013.The treatment consisted of concurrent chemoradiation,which included preoperative 5-luorouracil based chemotherapy and pelvic IMRT with a total of 50Gy/25 times,patients underwent rectal resection 4 to 8 weeks after of chemoradiatherapy.Evaluate its pathological and clinical effects.Results:Tumor pathologic grading(TRG) 0 grade were observed in 8 patients,1 grade were 12 patients,2 grade were 11 patients,3 grade were 20 patients,4 grade(pCR) were 9(15%) patients.Pathologic response rate was 86.7%.Downstaging rates were 55% for T staging and 51.9% for N staging.Surgical complications rate was 25.0%.Local recurrence rate(LRR) and distant metastasis rate(DMR) at 3-year were 11.6% and 13.3% respectively.The 3-year overall survival rates and disease-free survival(DFS)
were 88.3% and 85.5% respectively.Local recurrence free survival(LRFS) and distant recurrence free survival(DRFS) were 88.3% and 86.7% respectively.Kaplan-Meier and COX regression analysis showed that TRG grading influence on overall survival in patients with statistically significant.Conclusion:Preoperative intensity modulated radiation therapy with the concurrent chemotherapy in locally advanced rectal cancer patients has a good impact on tumor downstaging,improve the resection rate and survival rate.The 3-year local control was excellent.PCR and close
to the pCR was correlated to the favorable survival.%目的:观察并分析术前调强放疗同步化疗治疗局部晚期直肠癌的病理降期情况、临床疗效和预后因素.方法:
回顾性分析2010年1月1日至2013年7月31日间接受术前同步放化疗随后行根治性手术的60例初治Ⅱ、Ⅲ期直肠癌患者的临床资料.全部患者接受调强放射治疗,总剂量为50Gy/25次,同期行氟尿嘧啶为基础的化疗,放化疗结束后间隔4~8周行手术治疗.结果:肿瘤病理退缩分级(tumor regression grading,TRG)0级为8例、1级为 12例、2级为11例、3级为 20例、4级即病理完全缓解(complete responce rate,pCR)为9例,pCR率为15%,病理有效率为86.7%,T分期降期55%,N分期降期51.9%.手术并发症发生率为25.0%.3年总生存率(OS)为88.3%,3年无瘤生存率(DFS)为85.5%,3年局部复发率(LRR)为11.6%,3年远处转移率(DMR)为13.3%,3年无局部复发生存率(LRFS)为88.3%,3年无远处转移生存率(DRFS)为 86.7%.Kaplan-Meier分析及COX回归分析均表明TRG分级对患者总
生存期的影响具有统计学意义.结论:局部晚期直肠癌术前调强放疗同期化疗能使肿
瘤降期,提高手术切除率和生存率,3年局部控制好.pCR 和接近pCR 患者有更好的
生存期.
【总页数】4页(P1597-1600)
【作者】阿衣古丽·哈热;再依努尔·阿不都外力;张瑾熔;伊斯刊达·阿不力米提
【作者单位】新疆医科大学附属肿瘤医院胸腹放疗科,新疆乌鲁木齐 830011;新疆医科大学附属肿瘤医院胸腹放疗科,新疆乌鲁木齐 830011;新疆医科大学附属肿瘤医院胸腹放疗科,新疆乌鲁木齐 830011;新疆医科大学附属肿瘤医院胸腹放疗科,新疆乌鲁木齐 830011
【正文语种】中文
【中图分类】R735.37
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