Liu Luying, Cao Caineng, Zhu Yuan, Li Dechuan, Feng Haiyang, Luo Jialin, Tang Zhongzhu, Liu Peng, Lu Ke, Ju Haixing, Zhang Na
Department of Radiation Oncology, Zhejiang Cancer Hospital, No. 38, Guangji Road, Hangzhou, 310022, China.
Med Oncol. 2015 Mar;32(3):70. doi: 10.1007/s12032-015-0512-3. Epub 2015 Feb 19.
The aim of this study was to report long-term results of patients with locally advanced rectal cancer treated by neoadjuvant chemoradiotherapy with fluorouracil, leucovorin, and oxaliplatin. From February 2002 to November 2006, a total of 58 patients with locally advanced rectal cancer were recruited. Secondary endpoints included the cumulative incidence of local and distant recurrences, disease-free survival, and overall survival. The median follow-up time was 138 months (109-151 months). The cumulative incidence of local recurrence at 10 years was 12.1%. The cumulative incidence of distant recurrence at 10 years was 53.4%. The overall survival in the intention-to-treat population was 39.5% at 10 years. Disease-free survival in the intention-to-treat population was 41.8% at 10 years. Univariate analysis revealed that pathologic complete response was associated with local recurrence, distant recurrence, disease-free survival, and overall survival (p < .05). Distant recurrence remains the predominant pattern of failure for patients with locally advanced rectal cancer after preoperative chemoradiotherapy and total mesorectal excision. Pathologic complete response is an independent prognostic factor for locally advanced rectal cancer after preoperative chemoradiotherapy.
本研究的目的是报告接受氟尿嘧啶、亚叶酸钙和奥沙利铂新辅助放化疗的局部晚期直肠癌患者的长期结果。2002年2月至2006年11月，共招募了58例局部晚期直肠癌患者。次要终点包括局部和远处复发的累积发生率、无病生存期和总生存期。中位随访时间为138个月（109 - 151个月）。10年时局部复发的累积发生率为12.1%。10年时远处复发的累积发生率为53.4%。意向性治疗人群的10年总生存率为39.5%。意向性治疗人群的10年无病生存率为41.8%。单因素分析显示，病理完全缓解与局部复发、远处复发、无病生存期和总生存期相关（p < 0.05）。对于接受术前放化疗和全直肠系膜切除的局部晚期直肠癌患者，远处复发仍然是主要的失败模式。病理完全缓解是术前放化疗后局部晚期直肠癌的独立预后因素。
