Boonnuch Wiroon, Lohsiriwat Varut, Akaraviputh Thawatchai, Chinswangwatanakul Vitoon, Lohsiriwat Darin
Colorectal Unit, Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2009 Nov;92(11):1423-7.
To evaluate the surgical outcome of preoperative long-course chemoradiation therapy (PCRT) in patients with ultra low rectal cancer.
Medical records of patients with rectal adenocarcinoma located within the length of 5 cm from the anal verge, who underwent elective oncological resection between 2003 and 2006 at Siriraj Hospital, were reviewed. PCRT was performed in some patients based on tumor characteristics and surgeon's decision. Rate of sphincter preservation and other surgical outcomes were assessed.
Ninety-three patients with an average age of 60 years were studied. Twenty-seven (29%) received PCRT. There was no difference in demographic data and location of the tumor between PCRT and non-PCRT group. Patients with PCRT had a smaller size of tumor (2.6 vs. 5.0 cm, p < 0.001) and better tumor staging (p < 0.001). Complete pathological response was found in four patients with PCRT (15%). However, there was no significant difference in SPP rate between PCRT and non-PCRT group (37% vs. 36%, p = 0.95). Other surgical outcomes between the two groups were also not different.
PCRT did not increase rate of sphincter preservation in patients with low rectal cancer.
评估术前长程放化疗（PCRT）治疗超低位直肠癌患者的手术效果。
回顾了2003年至2006年期间在诗里拉吉医院接受择期肿瘤切除手术、距肛缘5厘米范围内患有直肠腺癌患者的病历。部分患者根据肿瘤特征和外科医生的决定接受了PCRT。评估了保肛率和其他手术效果。
研究了93例平均年龄为60岁的患者。27例（29%）接受了PCRT。PCRT组和非PCRT组在人口统计学数据和肿瘤位置方面没有差异。接受PCRT的患者肿瘤体积较小（2.6厘米对5.0厘米，p<0.001），肿瘤分期更好（p<0.001）。4例接受PCRT的患者（15%）出现了完全病理缓解。然而，PCRT组和非PCRT组的保肛率没有显著差异（37%对36%，p = 0.95）。两组之间的其他手术效果也没有差异。
PCRT并未提高低位直肠癌患者的保肛率。
