Loganadane Gokoulakrichenane, Servagi-Vernat Stéphanie, Schernberg Antoine, Schlienger Michel, Touboul Emmanuel, Bosset Jean-François, Huguet Florence
Department of Radiation Oncology, Tenon Hospital, Hôpitaux Universitaires Est Parisien, Pierre and Marie Curie Paris 6 University, Paris, France.
Department of Radiation Oncology, Besançon University Hospital, Besançon, France.
Eur J Cancer. 2016 May;58:83-9. doi: 10.1016/j.ejca.2016.02.005. Epub 2016 Mar 11.
Primary rectal squamous cell carcinoma (SCC) is an uncommon disease. Early reports stated that surgery is the most effective treatment. However, recent publications suggest conservative strategy with chemoradiation provides satisfactory results.
We have retrospectively studied the medical charts of 23 patients treated for a rectal SCC in two teaching hospitals in France between 1992 and 2013. Twenty-one patients received an exclusive chemoradiotherapy (CRT) and two a pre-operative CRT followed by a planned surgery. Patients received pelvic irradiation with a dose ranging from 36-45 Gy followed by a boost of 15-23 Gy. Twenty-two patients received a concurrent chemotherapy.
After CRT, the rate of clinical complete response was 83%. With a median follow-up of 85 months, 5-year overall survival rate was 86%. Five patients presented with a relapse. The 5-year disease-free survival rate was 81%. The 5-year colostomy-free survival rate was 65%. Three patients (13%) presented with grade III-IV late rectal toxicity.
Although retrospective, this is the largest cohort of patients treated with CRT for a rectal SCC. Exclusive CRT could result in high local control rate and prolonged survival in rectal SCC patients with a high rate of organ preservation.
原发性直肠鳞状细胞癌（SCC）是一种罕见疾病。早期报告称手术是最有效的治疗方法。然而，近期的出版物表明，放化疗的保守策略可提供令人满意的结果。
我们回顾性研究了1992年至2013年间在法国两家教学医院接受直肠SCC治疗的23例患者的病历。21例患者接受单纯放化疗（CRT），2例接受术前CRT，随后进行计划手术。患者接受盆腔照射，剂量范围为36 - 45 Gy，随后追加15 - 23 Gy。22例患者接受同步化疗。
CRT后，临床完全缓解率为83%。中位随访85个月，5年总生存率为86%。5例出现复发。5年无病生存率为81%。5年无结肠造口生存率为65%。3例患者（13%）出现III - IV级晚期直肠毒性。
尽管本研究为回顾性研究，但这是接受CRT治疗的直肠SCC患者的最大队列。单纯CRT可使直肠SCC患者获得较高的局部控制率和延长生存期，且器官保留率高。
