| 施利明,单晶晶,孙晓南.局部晚期直肠癌两组术前放疗剂量方案短期疗效分析[J].中华放射医学与防护杂志,2017,37(12):915-918,932 |
| 局部晚期直肠癌两组术前放疗剂量方案短期疗效分析 |
| Tumor pathological response and downstaging of locally advanced rectal cancer after neoadjuvant chemoradiotherapy:comparison of two radiation dose schedules |
| 投稿时间：2017-05-08 |
| DOI：10.3760/cma.j.issn.0254-5098.2017.12.007 |
| 中文关键词: 直肠癌 新辅助治疗 同步放化疗 剂量分割 |
| 英文关键词:Rectal cancer Neoadjuvant therapy Chemoradiotherapy Dose fractionation |
| 基金项目: |
|
| 摘要点击次数: 2708 |
| 全文下载次数: 1714 |
| 中文摘要: |
| 目的 评估局部晚期直肠癌新辅助放化疗不同放疗剂量短期疗效差异及耐受性。方法 回顾性分析2010年8月至2015年5月在本院接受新辅助放化疗的局部晚期直肠癌患者。根据放疗剂量分为46和50 Gy两组，同步化疗方案以卡培他滨为基础，<75岁且一般情况较好的患者联合奥沙利铂，所有患者完成新辅助放化疗和直肠癌根治术。结果 共有213例患者纳入研究，其中2010年8月至2013年8月接受46 Gy放疗剂量治疗61例，2013年9月至2015年5月接受50 Gy放疗剂量治疗152例，其中男性145例，女性68例；T2期22例，T3期180例，T4期11例；下、中、上段直肠癌分别为82、115和16例。两组患者年龄、性别、治疗前T分期及N分期差异无统计学意义（P>0.05），临床特征匹配。50和46 Gy组病理完全缓解（PCR）率分别为24.3%和18.0%（P>0.05）；病理缓解良好（GR）率分别为75.0%和67.2%（P>0.05）；T降期率分别为46.7%和39.3%（P>0.05）。T3N2/T4亚组分析：50和46 Gy组CR率分别为23.3%和6.3%（P>0.05）；GR （病理消退分级3+4）率分别为72.1%和50.0%，差异无统计学意义（P>0.05）。T降期率为46.5%和31.3%，差异无统计学意义（P>0.05）。结论 50 Gy较46 Gy放疗剂量治疗局部晚期直肠癌未能提高肿瘤病理缓解率及T降期率，对T3N2/T4期患者，两组差异也无统计学意义，远期疗效有待进一步随访验证。 |
| 英文摘要: |
| Objective To assess the short-term efficacy and tolerability of different radiotherapy doses schedules as 46 Gy and 50 Gy for locally advanced rectal cancer patients undergoing neoadjuvant chemoradiotherapy. Methods All patients with locally advanced rectal cancer who had received neoadjuvant chemoradiotherapy between Aug 2010 and May 2015 were enrolled. This retrospective analysis was performed according to the radiotherapy dose grouping of 46 Gy and 50 Gy groups. Concurrent chemotherapy regimen was capecitabine-based and oxaliplatin was added only when young patients (<75 years old) were in a good condition. Total mesorector excision was scheduled 6-8 weeks after concurrent chemoradiotherapy. Results Totally 213 patients were enrolled in our analysis, including 61 cases in 46 Gy group and 152 cases in 50 Gy group. There were 145 male and 68 female patients. There were 22 patients diagnosed clinically with T2, 180 with T3, and 11 with T4. Tumor distance from the anal verge was ≤ 5, >5 and <10 cm, or ≥ 10 cm in 82, 115 and 16 patients, respectively. T downstaging was observed in 95 (44.6%) patients, pathologic complete response (PCR) was shown in 48 (22.5%) patients. In the 46 Gy and 50 Gy groups, the rate of PCR was 18.0% vs.24.3% (P>0.05). In addition, good response rate (TRG 3+4) was 67.2% vs. 75.0% (P>0.05), and T downstaging rate was 39.3% vs. 46.7% (P>0.05). Subgroup analysis for T3N2/T4 patients, the rate of PCR was 6.3% vs. 23.3% (P>0.05), good response rate (TRG 3+4) was 50.0% vs. 72.1% (P>0.05), and T downstaging was 31.3% vs. 46.5% (P>0.05). There was no significant difference in treatment-related toxicity between the two groups. Conclusions The two different radiation dose fractionation (50 Gy vs. 46 Gy) had no impact on pathologic tumor regression and T downstaging for locally advanced rectal cancer. Nonetheless, a further long-term follow-up is warranted to confirm the preliminary study. |
| HTML 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|