伊立替康联合短程放射治疗用于中低位局部晚期直肠癌  

Irinotecan combined with short-term radiotherapy for treating locally advanced middle-low rectal cancer

作　　者：李怡霏 陶凯[2] LI Yifei;TAO Kai(Department of Radiotherapy,Pancreatic and Gastric Surgery,Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China;Department of Hepatobiliary,Pancreatic and Gastric Surgery,Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院/中国医学科学院肿瘤医院山西分院/山西医科大学附属肿瘤医院放射治疗科,山西太原030013 [2]山西省肿瘤医院/中国医学科学院肿瘤医院山西分院/山西医科大学附属肿瘤医院肝胆胰胃外科,山西太原030013

出　　处：《中国介入影像与治疗学》2024年第9期527-531,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的观察伊立替康联合短程放射治疗(放疗)用于中低位局部晚期直肠癌效果。方法回顾性分析140例接受全系膜切除术(TME)+FOLFOX6辅助化疗的直肠腺癌Ⅱ~Ⅲ期患者,根据新辅助放化疗(NCRT)方案将其分为伊立替康+短程放疗组(A组,n=67,总放射剂量25.0 Gy)及长程放化疗组(B组,n=73,总放射剂量50.4 Gy),比较2组放疗后短期疗效、毒副反应发生率及术后长期疗效。结果A组61例(61/67,91.04%)、B组65例(65/73,89.04%)完成NCRT+TME+FOLFOX6辅助化疗。A组放疗后12周完全缓解(CR)占比及术后3年无病生存率(DFS)均高于B组(P均<0.05)。组间放疗后12周疾病进展、疾病稳定及部分缓解占比,放疗后毒副反应发生率,以及术后5年总生存率、无复发生存率及远处转移发生率差异均无统计学意义(P均>0.05)。结论伊立替康联合短程放疗用于中低位局部晚期直肠癌有效且相对安全。Objective To observe the efficacy of irinotecan combined with short-term radiotherapy for treating locally advanced middle-low rectal cancer.Methods Totally 140 rectal adenocarcinoma patients of stageⅡ—Ⅲwho underwent total mesorectal excision(TME)and FOLFOX6 adjuvant chemotherapy were retrospectively enrolled.The patients were divided into irinotecan+short-term radiotherapy group(group A,n=67,total radiation dose of 25.0 Gy)and long-term chemoradiotherapy group(group B,n=73,total radiation dose of 50.4 Gy)according to the neoadjuvant chemoradiotherapy(NCRT)plan.The short-term efficacy,incidence of toxic and side effects after radiotherapy,as well as long-term postoperative efficacy were compared between groups.Results Sixty-one patients(61/67,91.04%)in group A and 65 patients(65/73,89.04%)in group B successfully completed NCRT+TME+FOLFOX6 adjuvant chemotherapy.The proportion of complete response(CR)12 weeks after radiotherapy and disease free survival rate(DFS)3 years after TMF in group A were both higher than those in group B(both P<0.05).No significant difference of proportion of progressive disease,stable disease and partial response 12 weeks after radiotherapy,the incidence of toxic and side effects 12 weeks after radiotherapy,overall survival,recurrence free survival nor distant metastasis 5 years after TME was found between groups(all P>0.05).Conclusion Irinotecan combined with short-term radiotherapy was effective and relatively safe for treating locally advanced middle-low rectal cancer.

关 键 词：直肠肿瘤 腺癌 新辅助治疗 

分 类 号：R735.37[医药卫生—肿瘤] R814.42[医药卫生—临床医学]