Lam Chung-Wah, Chen William Tzu-Liang, Liu Mu-Tai, Chang Cheng-Shyong, Huang Teng-Min, Hsu Ger-Hau, Chen Hong-Chang, Hsiao Koung-Hong, Chiu Chien-Min, You Jau-Jie
Department of Colorectal Surgery, Changhua Christian Hospital, Changhua, Taiwan.
Int Surg. 2005 Jan-Mar;90(1):53-9.
To evaluate the outcome of patients with locally advanced low rectal adenocarcinoma who required preoperative concurrent chemoradiotherapy (CCRT), a total of 22 patients underwent preoperative CCRT and radical resection for locally advanced low rectal adenocarcinoma. Patients received concurrent chemotherapy with high-dose 5-fluorouracil (5-FU) in continuous infusion and leucovorin and preoperative radiation with a mean dose of 50.4 Gy (range, 45-50.4 Gy). Radical resection surgery was performed 6 weeks after treatment. Fifty-five percent of patients achieved tumor downstaging, and 14% patients. showed pathological complete remission. No severe hematological and gastrointestinal toxicity of preoperative CCRT was noted. Sphincter-saving rate was 82%, and there were no deaths related to preoperative CCRT and surgery. Overall, 3-year survival rate was 69%, and a rate of locoregional recurrence was 13.6%. This study shows that many patients with locally advanced rectal cancer can be operated on with sphincter-saving radical resection surgery under good local control after preoperative concurrent chemoradiotherapy, which induces tumor downstaging.
为评估需要术前同步放化疗（CCRT）的局部晚期低位直肠癌患者的治疗结果，共有22例局部晚期低位直肠癌患者接受了术前CCRT及根治性切除术。患者接受高剂量5-氟尿嘧啶（5-FU）持续静脉滴注联合亚叶酸钙的同步化疗，并接受平均剂量为50.4 Gy（范围45-50.4 Gy）的术前放疗。治疗6周后进行根治性切除手术。55%的患者实现了肿瘤降期，14%的患者达到病理完全缓解。未观察到术前CCRT严重的血液学和胃肠道毒性。保肛率为82%，且无术前CCRT及手术相关死亡病例。总体而言，3年生存率为69%，局部区域复发率为13.6%。本研究表明，许多局部晚期直肠癌患者在术前同步放化疗诱导肿瘤降期并获得良好局部控制后，可接受保肛根治性切除手术。
