不同新辅助治疗方案对直肠癌患者TRG、手术并发症及LARS的影响  

Effect of Neoadjuvant Treatment on TRG,Surgical Complications and LARS in Patients with Rectal Cancer

作　　者：陈功勤 张洋[1] 郭慧[1] 欧阳洋[1] CHEN Gongqin;ZHANG Yang;GUO Hui;OUYANG Yang(Department of General Surgery,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院普通外科,长沙410008

出　　处：《肿瘤防治研究》2021年第12期1108-1112,共5页Cancer Research on Prevention and Treatment

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.17516)。

摘　　要：目的研究不同新辅助治疗方案对直肠癌患者肿瘤消退、手术并发症和低位前切除术综合征(LARS)的影响。方法选取新辅助治疗的直肠癌患者127名为研究对象。长程同步放化疗组42例,短程放疗+化疗组39例,化疗46例。收集患者病理学结果、临床资料及随访结果。选取其中可能对于直肠癌术后肿瘤退缩、手术并发症及低位前切除综合征产生影响的因素进行Logistic回归分析,多组单项有序资料使用Ridit分析。结果三组患者pCR率分别为:28.51%、10.3%和8.6%。三组发生围手术期并发症患者分别为14例(33.33%)、9例(23.07%)、10例(21.74%)。91例纳入研究,出现LARS症状者49例(53.84%),其中重度LARS患者17例(18.68%)。三组出现LARS症状者分别为27例(重度13例)、12例(重度2例)和9例(重度2例)。结论三种新辅助治疗方案均有较好的手术安全性;长程同步放化疗和短程放疗+化疗在肿瘤退缩方面均有优势,但长程同步放化疗更容易引起LARS症状,影响患者生活质量,在临床治疗方案选择上需要综合考虑。Objective To investigate the effects of different neoadjuvant treatments on tumor regression,surgical complications and low anterior resection syndrome(LARS)in patients with rectal cancer.Methods We included 127 patients with rectal cancer receiving neoadjuvant treatments,and they were divided into long-term concurrent chemoradiotherapy group(n=42),short-term radiotherapy+chemotherapy group(n=39)and chemotherapy group(n=46).The pathological results,clinical data and follow-up results were collected.The factors that may affect tumor regression,surgical complications and low anterior resection syndrome after rectal cancer surgery were statistically analyzed and concluded.Results The pCR rates were 28.51%,10.3%and 8.6%in long-term concurrent chemoradiotherapy group,short-term radiotherapy+chem otherapy group and chemotherapy group,respectively.There were 14(33.33%),9(23.07%)and 10(21.74%)patients with perioperative complications in three groups,respectively.A total of 91 patients were enrolled in the LARS study.There were 49(53.84%)cases with LARS symptoms,including 17(18.68%)cases with severe LARS.In three groups,there were 27 cases(including 13 cases of severe LARS),12 cases(including 2 cases of severe LARS)and 9 cases(including 2 cases of severe LARS)of LARS symptoms,respectively.Conclusion Three neoadjuvant treatments have good surgical safety.Long-term concurrent chemoradiotherapy and short-term radiotherapy+chemotherapy have advantages in tumor regression,but the former is more likely to cause LARS symptoms and affect the quality of life.Comprehensive consideration is needed in the choice of clinical treatments.

关 键 词：直肠癌 低位前切除综合征 肿瘤退缩分级 新辅助治疗 

分 类 号：R735.37[医药卫生—肿瘤]