沙特人群中直肠癌术前放化疗的五年结局：单机构经验
Five-year outcomes of preoperative chemoradiation for rectal carcinoma in Saudi population: single-institutional experience.
作者信息
AlSaeed Eyad Fawzi, Tunio Mutahir, Zubaidi Ahmad, Al-Obaid Omar, Ahmed Abdullah Kamal, Al-Omar Omar Abdulmohsen, Abid Emad Ahmed, Alsiwat Mohammed Jaber
机构信息
Mutahir Ali Tunio, MBBS, FCPS, Radiation Oncology,, Comprehensive Cancer Center,, King Fahad Medical City,, Riyadh 59046, Saudi Arabia, T: +966509001555, F: +96612889957,
出版信息
Ann Saudi Med. 2015 Jan-Feb;35(1):23-30. doi: 10.5144/0256-4947.2015.23.
OBJECTIVES
Preoperative chemoradiation (CRT) followed by surgery is the standard treatment for locally advanced rectal cancer (LARC). The outcomes of preoperative CRT in Saudi patients with LARC have not been widely studied. The study reports long-term outcomes after preoperative CRT followed by curative surgery in Saudi patients with LARC.
DESIGN AND SETTINGS
A retrospective, single-institutional study performed in the tertiary care oncology center in Saudi Arabia.
MATERIALS AND METHODS
A total of 154 out of 204 patients with LARC were treated with preoperative CRT and followed by surgery at the oncology center between September 2005 and November 2012. Data regarding the response rates, toxicity profile, locoregional control (LRC), distant metastasis control (DMC), overall survival (OS), and disease-free survival (DFS) rates were analyzed.
RESULTS
The median age of the study population was 56.6 years (range: 26-89). Predominant clinical stages were IIA (70 patients; 45.4%) and IIIB (49 patients; 31.8%). Majority of patients (79.8%) underwent a complete total mesorectal excision (TME). Complete pathological response (ypT0N0) was seen in 26 patients (16.8%). At 5 years, locoregional recurrence (LR) was reported in 12 patients (7.8%), and distant metastases were noted in 33 patients (21.4%). The 5-year cumulative LRC, DMC, OS, and DFS rates were 91%, 71.3%, 78%, and 64.8%, respectively. Stage, nodal status, circumferential margins, ypT0N0, and adjuvant chemotherapy were found to be important prognostic factors for DFS.
CONCLUSION
The results of preoperative CRT followed by surgery and adjuvant chemotherapy in Saudi population are comparable with international data.
目的
术前放化疗（CRT）后行手术是局部晚期直肠癌（LARC）的标准治疗方法。沙特LARC患者术前CRT的疗效尚未得到广泛研究。本研究报告了沙特LARC患者术前CRT后行根治性手术的长期疗效。
设计与背景
在沙特阿拉伯的三级医疗肿瘤中心进行的一项回顾性单机构研究。
材料与方法
2005年9月至2012年11月期间，肿瘤中心对204例LARC患者中的154例进行了术前CRT治疗，随后进行了手术。分析了有关缓解率、毒性特征、局部区域控制（LRC）、远处转移控制（DMC）、总生存期（OS）和无病生存期（DFS）率的数据。
结果
研究人群的中位年龄为56.6岁（范围：26 - 89岁）。主要临床分期为IIA期（70例患者；45.4%）和IIIB期（49例患者；31.8%）。大多数患者（79.8%）接受了完整的全直肠系膜切除术（TME）。26例患者（16.8%）出现完全病理缓解（ypT0N0）。5年时，12例患者（7.8%）报告有局部区域复发（LR），33例患者（21.4%）出现远处转移。5年累积LRC、DMC、OS和DFS率分别为91%、71.3%、78%和64.8%。发现分期、淋巴结状态、环周切缘、ypT0N0和辅助化疗是DFS的重要预后因素。
结论
沙特人群术前CRT后行手术及辅助化疗的结果与国际数据相当。
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