Kim Min Jung, Kim Sang Jin, Park Sung-Chan, Kim Dae Yong, Park Ji Won, Ryoo Seung-Bum, Jeong Seung-Yong, Park Kyu Joo, Oh Heung Kwon, Kim Duck-Woo, Kang Sung-Bum, Joo Jung Nam, Oh Jae Hwan
Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang Department of Surgery, Seoul National University College of Medicine Cancer Research Institute, Seoul National University Colorectal Cancer Center, Seoul National University Cancer Hospital, Seoul Department of Surgery, Seoul National University Bundang Hospital, Seongnam Biometric Research Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Medicine (Baltimore). 2016 Nov;95(47):e4925. doi: 10.1097/MD.0000000000004925.
The role of pelvic radiotherapy (RT) in stage IV rectal cancer with total mesorectal excision (TME) has not been defined. We evaluated the impact of RT on oncologic outcomes among patients with stage IV rectal cancer who underwent TME and performed a meta-analysis of published studies.The records of stage IV rectal cancer patients who underwent TME between August 2001 and December 2011 were reviewed. Patients who received pelvic RT (RT group) and those who did not (non-RT group) were matched using a propensity score. Oncologic outcomes were compared between the groups. A systematic literature search and meta-analysis was conducted.One hundred seventy-six patients were matched with propensity score matching, resulting in 39 patients in each group. The local recurrence-free survival (LRFS) of the RT group was significantly higher than that of the non-RT group (2-year LRFS: 100% vs 83.6%, respectively, P = 0.038). The overall survival, disease-free survival, and systemic recurrence were not significantly different between the groups. In the meta-analysis, the RT group had a reduced risk for loco-regional recurrence than the non-RT group (RR: 0.48, 95% confidence interval: 0.29-0.79).Pelvic RT might have benefits for loco-regional control in patients with stage IV rectal cancer who undergo TME.
盆腔放疗（RT）在接受全直肠系膜切除术（TME）的IV期直肠癌中的作用尚未明确。我们评估了放疗对接受TME的IV期直肠癌患者肿瘤学结局的影响，并对已发表的研究进行了荟萃分析。回顾了2001年8月至2011年12月期间接受TME的IV期直肠癌患者的记录。使用倾向评分对接受盆腔放疗的患者（放疗组）和未接受盆腔放疗的患者（非放疗组）进行匹配。比较两组的肿瘤学结局。进行了系统的文献检索和荟萃分析。通过倾向评分匹配对176例患者进行匹配，每组各有39例患者。放疗组的局部无复发生存率（LRFS）显著高于非放疗组（2年LRFS：分别为100%和83.6%，P = 0.038）。两组之间的总生存、无病生存和全身复发无显著差异。在荟萃分析中，放疗组局部区域复发风险低于非放疗组（RR：0.48，95%置信区间：0.29 - 0.79）。盆腔放疗可能对接受TME的IV期直肠癌患者的局部区域控制有益。
