放射治疗对挪威直肠癌局部复发的影响。

Impact of radiotherapy on local recurrence of rectal cancer in Norway.

作者信息

Hansen M H, Kjaeve J, Revhaug A, Eriksen M T, Wibe A, Vonen B

机构信息

Department of Digestive Surgery, University Hospital of North Norway, Tromso, Norway.

出版信息

Br J Surg. 2007 Jan;94(1):113-8. doi: 10.1002/bjs.5576.

DOI:10.1002/bjs.5576

PMID:17083107

Abstract

BACKGROUND

The purpose of this study was to analyse the impact of radiotherapy on local recurrence of rectal cancer in Norway after the national implementation of total mesorectal excision (TME).

METHODS

This was a prospective national cohort study of 4113 patients undergoing major resection of rectal carcinoma between November 1993 and December 2001.

RESULTS

The proportion of patients who had radiotherapy before or after operation increased from 4.6 per cent in 1994 to 23.0 per cent in 2001. The cumulative 5-year local recurrence rate decreased from 16.2 to 10.7 per cent. Multivariable analysis showed that preoperative radiotherapy significantly reduced local recurrence (hazard ratio 0.59 (95 per cent confidence interval 0.39 to 0.87)). The use of preoperative radiotherapy in patients from a local hospital offering radiotherapy was 50 per cent higher than that for patients from a hospital without such services (P = 0.003); cumulative 5-year local recurrence rates for these patients were 10.6 and 15.8 per cent respectively (P < 0.001).

CONCLUSION

Following national implementation of TME for rectal cancer, increased use of preoperative radiotherapy appeared to reduce recurrence rates further.

摘要

背景

本研究旨在分析在挪威全国实施全直肠系膜切除术（TME）后，放疗对直肠癌局部复发的影响。

方法

这是一项对1993年11月至2001年12月期间接受直肠癌大手术的4113例患者进行的前瞻性全国队列研究。

结果

术前或术后接受放疗的患者比例从1994年的4.6%增至2001年的23.0%。5年累计局部复发率从16.2%降至10.7%。多变量分析显示，术前放疗显著降低局部复发（风险比0.59（95%置信区间0.39至0.87））。在提供放疗的当地医院就诊的患者中，术前放疗的使用率比未提供此类服务的医院的患者高50%（P = 0.003）；这些患者的5年累计局部复发率分别为10.6%和15.8%（P < 0.001）。