Choi Yunseon, Lee Yun-Han, Park Sung Kwang, Cho Heunglae, Ahn Ki Jung
Department of Radiation Oncology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Department of Molecular Medicine, Keimyung University School of Medicine, Daegu, Korea.
Radiat Oncol J. 2016 Jun;34(2):113-20. doi: 10.3857/roj.2016.01725. Epub 2016 Jun 17.
The association between metabolism and cancer has been recently emphasized. This study aimed to find the prognostic significance of obesity in advanced stage rectal cancer patients treated with surgery and radiotherapy (RT).
We retrospectively reviewed the medical records of 111 patients who were treated with combined surgery and RT for clinical stage 2-3 (T3 or N+) rectal cancer between 2008 and 2014. The prognostic significance of obesity (body mass index [BMI] ≥25 kg/m(2)) in local control was evaluated.
The median follow-up was 31.2 months (range, 4.1 to 85.7 months). Twenty-five patients (22.5%) were classified as obese. Treatment failure occurred in 33 patients (29.7%), including local failures in 13 patients (11.7%), regional lymph node failures in 5, and distant metastases in 24. The 3-year local control, recurrence-free survival, and overall survival rates were 88.7%, 73.6%, and 87.7%, respectively. Obesity (n = 25) significantly reduced the local control rate (p = 0.045; 3-year local control, 76.2%), especially in women (n = 37, p = 0.021). Segregation of local control was best achieved by BMI of 25.6 kg/m(2) as a cutoff value.
Obese rectal cancer patients showed poor local control after combined surgery and RT. More effective local treatment strategies for obese patients are warranted.
新陈代谢与癌症之间的关联最近受到了关注。本研究旨在探讨肥胖在接受手术和放疗（RT）的晚期直肠癌患者中的预后意义。
我们回顾性分析了2008年至2014年间111例接受手术联合RT治疗的临床分期为2-3期（T3或N+）直肠癌患者的病历。评估了肥胖（体重指数[BMI]≥25kg/m²）对局部控制的预后意义。
中位随访时间为31.2个月（范围4.1至85.7个月）。25例患者（22.5%）被归类为肥胖。33例患者（29.7%）出现治疗失败，包括13例局部失败（11.7%）、5例区域淋巴结转移和24例远处转移。3年局部控制率、无复发生存率和总生存率分别为88.7%、73.6%和87.7%。肥胖患者（n = 25）显著降低了局部控制率（p = 0.045；3年局部控制率为76.2%），尤其是女性患者（n = 37，p = 0.021）。以BMI 25.6kg/m²为临界值时，局部控制的区分效果最佳。
肥胖的直肠癌患者在接受手术联合RT后局部控制效果较差。有必要为肥胖患者制定更有效的局部治疗策略。
