直肠癌放化疗后未行手术的回顾性研究  

A RETROSPECTIVE STUDY OF RECTAL CANCER WITHOUT SURGERY AFTER RADIOCHEMOTHERAPY IN THE REAL WORLD

作　　者：陈虹 宝莹娜[2] 乌新林[3] 林宇[2] 安志玲 梁骁 赵建国[2] CHEN Hong;BAO Yingna;WU Xinlin;LIN Yu;AN Zhiling;LIANG Xiao;ZHAO Jianguo(Inner Mongolia Medical University,Hohhot 010059,China;Department of Radiotherapy,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China;Department of Gastrointestinal surgery,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学第一临床医学院,内蒙古呼和浩特010059 [2]内蒙古医科大学附属医院放疗科,内蒙古呼和浩特010050 [3]内蒙古医科大学附属医院胃肠外科,内蒙古呼和浩特010050

出　　处：《疾病监测与控制》2023年第4期253-257,262,共6页Journal of Diseases Monitor and Control

基　　金：内蒙古科技计划项目(2019GG150)。

摘　　要：目的总结分析直肠癌患者放化疗后因各种原因未行手术的疗效和预后。方法回顾性分析2012年2月至2021年10月在我院放疗科接受放化疗后未行手术的直肠癌患者52例,分析患者临床缓解情况和不良反应发生率。用Kaplan-Meier法计算患者总生存(over survival,OS),采用单因素分析影响生存预后的危险因素。结果52例直肠癌患者治疗后局部缓解率82.6%,CR率5.7%,PR率76.9%,SD率13.5%,PD率3.8%;1年OS为59.3%。11例转移性直肠癌患者的1年OS为36.4%,41例局部晚期直肠癌患者1年OS为65.5%。治疗过程中出现的不良反应多为1级、2级,给予对症支持治疗均可缓解。单因素分析显示M分期与患者1年OS降低显著相关。结论放化疗后未行手术直肠癌患者直肠局部缓解率较高,不良反应可耐受。达到临床完全缓解的患者,可能从观察等待策略中获益,初诊时M1分期与患者生存预后差显著相关。Objective To summarize and analyze the efficacy and prognosis of rectal cancer patients who did not undergo surgery after chemoradiotherapy for various reasons.Methods A retrospective analysis of 52 patients with rectal cancer who did not undergo surgery after chemoradiotherapy in our department from February 2012 to October 2021.Clinical remission and incidence of adverse reactions were analyzed.Kaplan-Meier method was used to calculate the overall survival(OS),and univariate analysis was used to analyze the risk factors for survival.Results After treatment,the local remission rate was 82.6%,CR rate was5.7%,PR rate 76.9%,SD rate 13.5% and PD rate 3.8%;The 1-year OS was 59.3%.The 1-year OS of 11 metastatic rectal cancer patients was 36.4%.The 1-year OS of 41 locally advanced rectal cancer patients was 65.5%.Most of the adverse reactions during treatment are grade 1 or 2,which could be alleviated after symptomatic and supportive treatment.Univariate analysis showed that M stage was significantly associated with 1-year OS.Conclusions For rectal cancer patients without surgery after chemoradiotherapy,the local remission rate of patients after chemoradiotherapy is high,and the adverse reactions are tolerable.Patients with c CR may benefit from watch and wait Strategy.M1 stage at initial diagnosis is significantly associated with poor survival outcomes.

关 键 词：直肠癌 放化疗 疗效 不良反应 观察等待策略 

分 类 号：R735.37[医药卫生—肿瘤]