Peng Jianhong, Lin Junzhong, Zeng Zhifan, Wu Xiaojun, Chen Gong, Li Liren, Lu Zhenhai, Ding Peirong, Wan Desen, Pan Zhizhong
Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China.
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China.
Oncol Lett. 2017 Oct;14(4):4543-4550. doi: 10.3892/ol.2017.6764. Epub 2017 Aug 17.
Our previous study reported the favorable short-term outcome and good tolerance of integrating oxaliplatin into capecitabine-based (XELOX regimen) preoperative chemoradiotherapy (CRT) for locally advanced rectal cancer (LARC). The present study reported the long-term oncological outcome of this phase II study. A total of 47 patients with rectal adenocarcinoma (stage II or III) were enrolled and received radiotherapy (46 Gy in 23 fractions) in combination with capecitabine (1,000 mg/m, twice daily, on days 1-14 and 22-35) and oxaliplatin (130 mg/m on days 1 and 22). Overall survival (OS) rate, disease-free survival (DFS) rate and cumulative incidence of recurrences and long-term complications were calculated or observed. As a result, 41 patients underwent surgery after preoperative CRT, and the cumulative OS rates at 1, 3 and 5 years for these patients were 100.0, 84.5 and 81.8%, respectively. For the 38 patients who received R0 resection, the cumulative OS rates at 1, 3 and 5 years were 100.0, 89.0 and 86.2%, respectively, while the cumulative DFS rates at 1, 3 and 5 years were 94.6, 75.3 and 69.7%, respectively. After follow-up at 84 months, the cumulative incidence rates of local and distant recurrences at 5 years were 6.6 and 28.2%, respectively. Oxaliplatin-associated long-term complications were seldom observed. Overall, the addition of oxaliplatin to capecitabine-based preoperative radiotherapy achieved favorable OS and DFS without increased long-term complications in patients with LARC. Therefore, this preoperative CRT strategy is a feasible option for such patients.
我们之前的研究报告了将奥沙利铂纳入以卡培他滨为基础的（XELOX方案）术前放化疗（CRT）用于局部晚期直肠癌（LARC）的良好短期疗效和耐受性。本研究报告了该II期研究的长期肿瘤学结局。共纳入47例直肠腺癌（II期或III期）患者，接受放疗（23次分割，共46 Gy）联合卡培他滨（1000 mg/m²，每日2次，第1 - 14天和第22 - 35天）及奥沙利铂（第1天和第22天，130 mg/m²）。计算或观察总生存（OS）率、无病生存（DFS）率以及复发和长期并发症的累积发生率。结果，41例患者在术前CRT后接受了手术，这些患者1年、3年和5年的累积OS率分别为100.0%、84.5%和81.8%。对于38例接受R0切除的患者，1年、3年和5年的累积OS率分别为100.0%、89.0%和86.2%，而1年、3年和5年的累积DFS率分别为94.6%、75.3%和69.7%。在84个月的随访后，5年时局部和远处复发的累积发生率分别为6.6%和28.2%。很少观察到与奥沙利铂相关的长期并发症。总体而言，在以卡培他滨为基础的术前放疗中添加奥沙利铂可使LARC患者获得良好的OS和DFS，且不会增加长期并发症。因此，这种术前CRT策略对此类患者是一种可行的选择。
