Yang Shung-Haur, Lee Rheun-Chuan, Chen Chien-Chih, Jiang Jeng-Kae, Lin Jen-Kou, Li Anna Fen-Yau, Liang Wen-Yih, Wang Ling-Wei
Division of Colon and Rectal Surgery, Department of Surgery, Cancer Center Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Hepatogastroenterology. 2005 May-Jun;52(63):765-9.
BACKGROUND/AIMS: The significance of tumor volume and its change after concurrent chemoradiotherapy (CCRT) was evaluated.
Standard-dose external radiation and oral UFUR plus leucovorin were used to treat 30 middle and lower rectal adenocarcinoma patients. Volume of tumor calculated from images obtained by dynamic MRI of the rectum before and after CCRT was compared to pathological results after definite resection and other clinical data.
The T-stage in 15 patients (50%), the N-stage in 13 (72.2%), and overall, the TNM stage in 18 (60%), were downstaged, including 7 (23.3%) with complete responses (CR). Volume of tumor before CCRT (Vpre) and after CCRT (VPost) was 10.3+/-6.1cm3 and 4.2+/-2.2cm3, respectively, and VPre correlated with initial T stage, N stage, age, and location. The net decrease ratio (NDR) of tumor volume was related to Vpre and initial T stage. As to the downstaging effect, VPre was related to incidence of CR; NDR was related to the downstaging of the N stage.
All tumors showed volume reduction after CCRT, but the downstaging benefits were not in proportion to the size change. Initially larger tumors had higher ratios of volume reduction, and smaller tumors had higher chance of CR.
背景/目的：评估同步放化疗（CCRT）后肿瘤体积及其变化的意义。
采用标准剂量外照射及口服优福定加亚叶酸钙治疗30例中低位直肠腺癌患者。将CCRT前后通过直肠动态MRI获得的图像计算出的肿瘤体积与根治性切除后的病理结果及其他临床资料进行比较。
15例患者（50%）的T分期、13例患者（72.2%）的N分期以及总体18例患者（60%）的TNM分期降低，其中7例（23.3%）达到完全缓解（CR）。CCRT前肿瘤体积（Vpre）和CCRT后肿瘤体积（VPost）分别为10.3±6.1cm³和4.2±2.2cm³，VPre与初始T分期、N分期、年龄及部位相关。肿瘤体积净缩小率（NDR）与Vpre及初始T分期相关。关于降期效果，VPre与CR发生率相关；NDR与N分期的降期相关。
所有肿瘤在CCRT后均显示体积缩小，但降期获益与大小变化不成比例。初始较大的肿瘤体积缩小比例较高，而较小的肿瘤CR机会较高。
