陈露, 张阳, 张岸梅, 崔天祥, 钟良志, 杨帆, 李光辉. 短程放疗联合同步化疗及延迟手术治疗高危局部进展期直肠腺癌疗效分析[J]. 中国肿瘤临床, 2023, 50(12): 616-620. DOI: 10.12354/j.issn.1000-8179.2023.20221714
引用本文: 陈露, 张阳, 张岸梅, 崔天祥, 钟良志, 杨帆, 李光辉. 短程放疗联合同步化疗及延迟手术治疗高危局部进展期直肠腺癌疗效分析[J]. 中国肿瘤临床, 2023, 50(12): 616-620. DOI: 10.12354/j.issn.1000-8179.2023.20221714
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Lu Chen, Yang Zhang, Anmei Zhang, Tianxiang Cui, Liangzhi Zhong, Fan Yang, Guanghui Li. Efficacy of short-course radiotherapy concurrent with chemotherapy and delayed surgery for high-risk locally advanced rectal adenocarcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(12): 616-620. DOI: 10.12354/j.issn.1000-8179.2023.20221714
Citation: Lu Chen, Yang Zhang, Anmei Zhang, Tianxiang Cui, Liangzhi Zhong, Fan Yang, Guanghui Li. Efficacy of short-course radiotherapy concurrent with chemotherapy and delayed surgery for high-risk locally advanced rectal adenocarcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(12): 616-620. DOI: 10.12354/j.issn.1000-8179.2023.20221714
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短程放疗联合同步化疗及延迟手术治疗高危局部进展期直肠腺癌疗效分析

Efficacy of short-course radiotherapy concurrent with chemotherapy and delayed surgery for high-risk locally advanced rectal adenocarcinoma

    摘要
  • 摘要:
      目的  探讨短程放疗联合同步化疗及延迟手术治疗高危局部进展期直肠腺癌患者的近期疗效及不良反应。
      方法  回顾性分析2015年9月至2021年3月于陆军军医大学第二附属医院接受术前短程放疗联合同步化疗及延迟手术的22例高危局部进展期直肠腺癌患者临床资料。所有患者均接受短程放疗联合mFOLFOX6方案或卡培他滨同步化疗，放疗结束至手术间隔时间约12周。评估分析治疗后的病理完全缓解率、降期率、相关不良反应、手术情况等。
      结果  22例患者均完成短程放疗同步化疗，术后病理完全缓解率为13.6%，降期率为50.0%，3～4级急性不良反应的发生率为36.4%，无治疗相关死亡发生，2年无疾病生存率为59.7%，2年总生存率为75.9%。
      结论   短程放疗同步化疗和延迟手术治疗高危局部进展期直肠腺癌的治疗模式可行，急性不良反应可以耐受，能有效提高降期率。

     

    Abstract:
      Objective  To investigate the short-term efficacy and toxicity of short-course radiotherapy with adjuvant chemotherapy and delayed surgery in patients with high-risk locally advanced rectal adenocarcinoma (LARC).
      Methods  We performed a retrospective analysis of 22 high-risk LARC patients who received preoperative short-course radiotherapy with adjuvant chemotherapy and delayed surgery in The Second Affiliated Hospital of Army Medical University between September 2015 and March 2021. All patients received short-course radiotherapy in combination with mFOLFOX6 regime or concurrent capetabine chemotherapy with a time interval of approximately 12 weeks between radiotherapy and surgery. The pathologic complete response (pCR) rate, downstaging rate, treatment-related toxicity, and surgical outcomes after treatment were analyzed.
      Results  All 22 patients completed short-course radiotherapy and adjuvant chemotherapy with a pCR and downstaging rate of 13.6% and 50%, respectively. Grade 3–4 acute toxicity occurred in 36.4% of patients. No treatment-related deaths were reported, and the 2-year overall survival and disease-free survival rates were 75.9% and 59.7%, respectively.
      Conclusions  Short-course radiotherapy combined with adjuvant chemotherapy and delayed surgery is a feasible treatment option for high-risk LARC. Acute toxicity can be tolerated, and the rate of down staging can be successfully increased.

     

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