Chen Gong, Zhang Rongxin, Wu Xiaojun, Lu Zhenhai, Ding Peirong, Pan Zhizhong, Wan Desen
Department of Colorectal Surgery, Cancer Center, Sun Yat-Sen University, State Key Laboratory of Oncology in South China, Guangzhou 510060, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2016 Jun;19(6):664-7.
To explore the efficacy prediction of the locally advanced rectal cancer patients, especially those with pathological complete response(pCR), receiving neoadjuvant chemoradiotherapy in order to execute precise preoperative neoadjuvant chemoradiotherapy.
From January 2000 to January 2011, 125 patients diagnosed as locally advanced rectal cancer receiving preoperative neoadjuvant chemoradiotherapy in our department with complete data were enrolled in this study, including 85 males and 40 females with mean age of 54(15 to 77) years old. All the patients received radiotherapy with 46 Gy(23 times) and administered XELOX regimen (oxaliplatin 100 mg/m(2) plus capecitabine 2 000 mg/m(2)) for 2 courses simultaneously, and underwent radical operation 6 to 8 weeks after chemoradiotherapy. The data of these patients were analyzed retrospectively. Pathological remission was divided into 4 grades. Patients achieving grade 4 were defined as pCR, and those achieving above grade 2 were defined as better response. Logistic regression analysis was used to identify significant predictors of pCR.
Among 125 patients, 16(12.8%) achieved pCR status, and 90(72.0%) had better response to the neoadjuvant chemoradiotherapy. Logistic regression analysis showed that age(OR:1.060, P=0.037) and preoperative positive lymph nodes detected by endorectal ultrasonography (OR:0.059, P=0.006) were independent predictors of pCR after neoadjuvant chemoradiotherapy.
Preoperative existence of lymph node metastasis around bowel indicates the poor response to neoadjuvant chemoradiotherapy. Age is associated with pCR in patients receiving neoadjuvant chemoradiotherapy.
探讨局部晚期直肠癌患者，尤其是那些达到病理完全缓解（pCR）的患者，接受新辅助放化疗后的疗效预测，以便实施精准的术前新辅助放化疗。
选取2000年1月至2011年1月期间在我科接受术前新辅助放化疗且资料完整的125例局部晚期直肠癌患者，其中男性85例，女性40例，平均年龄54岁（15至77岁）。所有患者均接受46 Gy（23次）的放疗，并同时给予XELOX方案（奥沙利铂100 mg/m²加卡培他滨2000 mg/m²）化疗2个疗程，放化疗后6至8周行根治性手术。对这些患者的数据进行回顾性分析。病理缓解分为4级。达到4级的患者被定义为pCR，达到2级以上的患者被定义为反应较好。采用Logistic回归分析确定pCR的显著预测因素。
125例患者中，16例（12.8%）达到pCR状态，90例（72.0%）对新辅助放化疗反应较好。Logistic回归分析显示，年龄（OR：1.060，P = 0.037）和经直肠超声检查术前阳性淋巴结（OR：0.059，P = 0.006）是新辅助放化疗后pCR的独立预测因素。
术前肠周存在淋巴结转移提示对新辅助放化疗反应较差。年龄与接受新辅助放化疗患者的pCR有关。
