Darunikorn Pichayada, Puataweepong Putipun, Dhanachai Mantana, Dangprasert Somjai, Swangsilpa Thiti, Sitathanee Chomporn, Jiarpinitnun Chuleeporn, Pattaranutaporn Poompis, Boonyawan Keeratikan, Chansriwong Pichai
Radiation and Oncology Unit, Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand E-mail :
Asian Pac J Cancer Prev. 2015;16(16):7315-9. doi: 10.7314/apjcp.2015.16.16.7315.
The study analyzed and compared the long term outcome in locally advanced rectal cancer treated with preoperative and postoperative concurrent chemoradiation (CCRT).
A retrospective review of 105 patients with stage T3-T4 or regional lymph node positive adenocarcinoma of rectum treated with preoperative or postoperative CCRT at Ramathibodi Hospital during 2005 to 2010 was performed. The results of treatment were reported with 5-year overall survival (OS), 5- year locoregional recurrence free survival (LRFS), and toxicity according to preoperative versus postoperative concurrent chemoradiation (CCRT) groups.
Among 105 patients, 34 (32%) were treated with preoperative CCRT and 71 (68%) with postoperative CCRT. At the median follow-up time of 50.5 months (range 2-114 months), five-year OS and LRFS of all patients were 87% and 91.6%, respectively. The study found no difference in 5-year OS (81.7% vs 89.2 %) or LRFS (83.4% vs 95.1%) between preoperative versus postoperative CCRT. Seven cases of loco-regional recurrence were diagnosed, 4 (11.8%) after preoperative CCRT and 3 (4.2%) after postoperative CCRT. The recurrent sites were anastomosis in all patients. There was no significant factor associated with outcome after univariate and multivariate testing. Grade 3 or 4 acute and late complications were low in both preoperative and postoperative CCRT groups.
Locally advanced rectum cancer patients experience good results with surgery and adjuvant concurrent chemoradiation.
本研究分析并比较了术前和术后同步放化疗（CCRT）治疗局部晚期直肠癌的长期疗效。
对2005年至2010年期间在拉玛蒂博迪医院接受术前或术后CCRT治疗的105例T3 - T4期或区域淋巴结阳性的直肠腺癌患者进行回顾性分析。根据术前与术后同步放化疗（CCRT）组报告治疗结果，包括5年总生存率（OS）、5年无局部区域复发生存率（LRFS）和毒性反应。
105例患者中，34例（32%）接受术前CCRT治疗，71例（68%）接受术后CCRT治疗。中位随访时间为50.5个月（范围2 - 114个月），所有患者的5年OS和LRFS分别为87%和91.6%。研究发现术前与术后CCRT的5年OS（81.7%对89.2%）或LRFS（83.4%对95.1%）无差异。诊断出7例局部区域复发，术前CCRT后4例（11.8%），术后CCRT后3例（4.2%）。所有患者的复发部位均为吻合口。单因素和多因素检验均未发现与预后相关的显著因素。术前和术后CCRT组3级或4级急性和晚期并发症发生率均较低。
局部晚期直肠癌患者手术联合辅助同步放化疗效果良好。
