进展期低位直肠癌新辅助放化疗后治疗反应及预后分析  

Treatment Response and Prognosis of Advanced Low Rectal Cancer after Neoadjuvant Radiotherapy and Chemotherapy

作　　者：庄咏 吴贤毅[1] 杨春康[1] ZHUANG Yong;WU Xianyi;YANG Chunkang(Fujian Cancer Hospital,Affiliated Cancer Hospital of Fujian Medical University,Fuzhou 350014,China)

机构地区：[1]福建省肿瘤医院,福建医科大学附属肿瘤医院,福建福州350014

出　　处：《中国医药指南》2021年第34期20-22,共3页Guide of China Medicine

摘　　要：目的研究进展期低位直肠癌新辅助放化疗后治疗反应及预后价值。方法采用回顾性研究方法,收集福建省肿瘤医院胃肠外科2013年10月至2018年3月收治的直肠癌患者的临床资料,选择临床分期为T3-4N0或T1-4N+并行术前长程新辅助放化疗的低位直肠癌患者为研究对象。依据术后病理结果,将入组患者分为反应组及无反应组,对两组患者的近期疗效及长期生存结果进行分析。主要观察指标:3年总生存期(overall survival,OS)、3年无复发生存期(relapse-free survival,RFS)。结果入组患者45例,其中反应组34例(75.56%)、无反应组11例(24.44%)。术后病理两组在ypT、ypN分期上存在显著差异(P <0.05)3年RFS分别为反应组94.12%,无反应组54.55%,差异有统计学意义(P=0.008)。3年OS分别为反应组97.06%,无反应组81.82%,差异无统计学意义(P=0.06)。结论良好的放化疗反应能够改善局部进展期低位直肠癌患者的无复发生存率,良好的放化疗反应可提示较好的预后。Objective To study the therapeutic response and prognostic value of neoadjuvant radiotherapy and chemotherapy for advanced low rectal cancer.Methods The clinical data of rectal cancer patients treated in the Department of gastrointestinal surgery of Fujian cancer hospital from October 2013 to March 2018 were collected retrospectively. Patients with low rectal cancer with clinical stage T3-4 N0 or T1-4 N + and preoperative long-term neoadjuvant radiotherapy and chemotherapy were selected as the research objects. According to the postoperative pathological results, the patients were divided into reaction group and non reaction group. The short-term efficacy and long-term survival results of the two groups were analyzed. Main outcome measures: 3-year overall survival(OS)and 3-year relapse free survival(RFS). Results Forty-five patients were enrolled, including 34 cases(75.56%) in the response group and 11 cases(24.44%) in the non response group. there are significant differences in ypT and ypN staging between the two groups after surgery(P<0.05).The 3-year RFs were 94.12% in the response group and 54.55% in the non response group(P=0.008). The 3-year OS was 97.06% in the response group and 81.82% in the non response group,respectively. The difference was not statistically significant(P=0.06). Conclusion Good response to radiotherapy and chemotherapy can improve the recurrence free survival rate of patients with locally advanced low rectal cancer. Good response to radiotherapy and chemotherapy suggests a better prognosis.

关 键 词：直肠癌 放化疗 手术 病理反应 预后 

分 类 号：R735.37[医药卫生—肿瘤]