Kuriu Yoshiaki, Kokuba Yukihito, Murayama Yasutoshi, Komatsu Shuhei, Shiozaki Atsushi, Ikoma Hisashi, Nakanishi Masayoshi, Ichikawa Daisuke, Fujiwara Hitoshi, Okamoto Kazuma, Ochiai Toshiya, Otsuji Eigo
Dept. of Surgery, Kyoto Prefectural University of Medicine, Japan.
Gan To Kagaku Ryoho. 2012 Nov;39(12):1951-3.
A total of 37 patients treated with chemoradiotherapy between 2008 and 2011 were analyzed. Radiotherapy was administered in fractions of 1.8 Gy/day for 25 days. S-1 was administered orally in a fixed daily dose of 80 mg/m2 on days 1-5, 8-12, 22-26, and 29-33. Irinotecan(CPT-11 80 mg/m2) was infused on days 1, 8, 22, and 29. Curative surgery was performed 6-8 weeks later. The clinical downstaging rate was 40%. During the median follow-up time of 664 days, 37 patients survived. Recurrence was found in 8 patients. Local recurrence (pelvic lymph node metastasis) was only observed in 1 patient. Grade 3-4 toxic effects, including interstitial pneumonia, occurred in 27% of the patients. Neoadjuvant chemoradiotherapy may result in excellent local control with acceptable morbidity. However, longer follow up is required to assess neoadjuvant chemoradiotherapy for locally advanced rectal cancers.
对2008年至2011年间接受放化疗的37例患者进行了分析。放疗按每日1.8 Gy分剂量进行,共25天。S-1在第1 - 5天、第8 - 12天、第22 - 26天和第29 - 33天以每日固定剂量80 mg/m²口服给药。伊立替康(CPT-11 80 mg/m²)在第1天、第8天、第22天和第29天静脉输注。6 - 8周后进行根治性手术。临床降期率为40%。在中位随访时间664天期间,37例患者存活。8例患者出现复发。仅1例患者观察到局部复发(盆腔淋巴结转移)。27% 的患者出现3 - 4级毒性反应,包括间质性肺炎。新辅助放化疗可能会实现良好的局部控制,且发病率可接受。然而,需要更长时间的随访来评估新辅助放化疗用于局部晚期直肠癌的效果。