Marano P, Barbaro B, De Franco A, Vecchioli A, Cellini N, Valentini V, Coco C, Doglietto G B, Vecchio F M
Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma.
Radiol Med. 1992 Sep;84(3):261-73.
In our University, many different radiosurgical options are available to treat rectal carcinoma. Selecting the patients to submit to treatment requires accurate clinical and radiological staging. A team of radiologists, radiotherapists, surgeons, endoscopists and pathologists has been created to stage the patients and to follow the final results. The team have decided the diagnostic and therapeutic protocols. The patients with rectal cancer undergo radiotherapy after staging and are subsequently restaged. If indicated, surgery is performed and histology is compared with restaging, to assess the accuracy of the diagnostic procedures. All diagnostic and therapeutic decisions are made collectively by the team, during scheduled meetings. All data are stored in a computer program. This paper deals with the working method we used, its advantages and the outcome of the first 23 studied patients. Restaging was compared with histology: transrectal US (performed in 8 patients) showed 100% accuracy in evaluating local tumor spread (T). CT had 91% accuracy in defining T and 60% accuracy in N, with a tendency to overstaging. In 78% of patients > 50% reduction of tumor size was observed and the distance from the anal canal increased in 95.5%. This study will provide the overall accuracy of the clinico-radiologic staging, the survival rates and the indication of prognostic signs.
在我们大学，有许多不同的放射外科治疗方案可用于治疗直肠癌。选择接受治疗的患者需要准确的临床和放射学分期。已经组建了一个由放射科医生、放疗科医生、外科医生、内镜医生和病理科医生组成的团队来对患者进行分期并跟踪最终结果。该团队制定了诊断和治疗方案。直肠癌患者在分期后接受放疗，随后再次分期。如果有指征，则进行手术，并将组织学结果与再次分期结果进行比较，以评估诊断程序的准确性。所有诊断和治疗决策均由该团队在定期会议上共同做出。所有数据都存储在一个计算机程序中。本文介绍了我们使用的工作方法、其优点以及首批23例研究患者的结果。将再次分期结果与组织学结果进行比较：经直肠超声（8例患者进行了此项检查）在评估局部肿瘤扩散（T）方面显示出100%的准确性。CT在确定T分期方面的准确性为91%，在确定N分期方面的准确性为60%，有过度分期的倾向。在78%的患者中观察到肿瘤大小缩小>50%，95.5%的患者肛管距离增加。本研究将提供临床放射学分期的总体准确性、生存率以及预后征象的指征。
