Department of Radiation Oncology, Kaiser Permanente, 4950 Sunset Boulevard, 2nd Floor Station B, Los Angeles, CA 90027, USA.
Tech Coloproctol. 2012 Oct;16(5):349-54. doi: 10.1007/s10151-012-0848-z. Epub 2012 Jun 19.
Squamous cell carcinoma (SCC) of the rectum is a rare disorder. There is currently no effective method as to how best treat patients with this condition. The purpose of this study was to review a single tertiary institution's experience.
A retrospective chart review was conducted of all patients who presented with documented SCC of the rectum over a 10-year period (2000-2010). During the study period, all patients were offered chemoradiation as an initial treatment modality [a fluorouracil (5-FU)-based regimen in conjunction with mitomycin or cisplatin].
Six patients presented with primary rectal SCC. Mean patient age was 60 years. The majority of patients were female (83 %). The most common presenting symptom was rectal bleeding (67 %). The mean distance from the inferior tumor margin to the anal verge was 6 cm. Two patients (33 %) presented with stage II disease, and 4 (67 %) were stage III. Five patients (83 %) received chemoradiation therapy initially, and 1 patient underwent abdominoperineal resection after refusing chemoradiation. Two additional patients (33 %) underwent salvage surgery. During a mean follow-up of 44 months, 4 patients (66 %) were alive without evidence of disease.
Based on the results of this cases series, chemoradiation as an initial primary therapy appears to be beneficial for patients with primary SCC of the rectum. A 5-FU chemotherapy-based regimen in conjunction with fractionated radiotherapy appears to be effective for local control of the disease.
直肠鳞状细胞癌(SCC)是一种罕见的疾病。目前尚无针对该疾病的最佳治疗方法。本研究旨在回顾单一的三级医疗机构的经验。
对 10 年间(2000-2010 年)所有记录在案的直肠 SCC 患者进行了回顾性图表分析。在研究期间,所有患者均接受了放化疗作为初始治疗方法[氟尿嘧啶(5-FU)联合丝裂霉素或顺铂]。
6 例患者表现为原发性直肠 SCC。患者平均年龄为 60 岁。大多数患者为女性(83%)。最常见的首发症状是直肠出血(67%)。肿瘤下缘至肛门的平均距离为 6cm。2 例(33%)患者为 II 期疾病,4 例(67%)为 III 期。5 例(83%)患者最初接受了放化疗,1 例患者因拒绝放化疗而行腹会阴切除术。另外 2 例(33%)患者接受了挽救性手术。在平均随访 44 个月期间,4 例(66%)患者无疾病证据且存活。
基于该病例系列的结果,放化疗作为初始的主要治疗方法似乎对原发性直肠 SCC 患者有益。5-FU 化疗联合分割放疗似乎对疾病的局部控制有效。