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识别接受新辅助化疗的低位直肠癌患者复发的预测因素:短程和长程放化疗的直接比较。

Identification of Predictors of Recurrence in Patients with Lower Rectal Cancer Undergoing Neoadjuvant Chemotherapy: A Direct Comparison of Short-Course and Long-Course Chemoradiotherapy.

机构信息

Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Japan.

Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu,

出版信息

Oncology. 2019;96(2):70-78. doi: 10.1159/000492617. Epub 2018 Sep 18.

Abstract

OBJECTIVE

This study aimed to investigate clinicopathological responses and oncological outcome in patients receiving short- or long-course chemoradiotherapy (CRT) and to assess the predictive factor for recurrence in each treatment.

METHODS

A total of 118 rectal cancer patients receiving preoperative CRT were enrolled. Clinicopathological responses and oncological outcome in patients receiving short- or long-course CRT were investigated.

RESULTS

Despite there being no significant differences in the prognosis of disease-free survival (DFS) based on TNM stage classification in patients receiving long-course CRT, patients with advanced stage demonstrated poor DFS after short-course CRT. The presence of lymph node metastasis was a predictor of poor DFS in short-course CRT, whereas poor pathological response was a predictor of recurrence in long-course CRT.

CONCLUSIONS

Distinct predictors of recurrence depending on the CRT course might be needed to discriminate candidates from rectal cancer patients receiving preoperative CRT who might benefit from more intensive adjuvant therapy after surgery.

摘要

目的

本研究旨在探讨接受短程或长程放化疗(CRT)的患者的临床病理反应和肿瘤学结局,并评估每种治疗方法中复发的预测因素。

方法

共纳入 118 例接受术前 CRT 的直肠癌患者。研究了接受短程和长程 CRT 的患者的临床病理反应和肿瘤学结局。

结果

尽管长程 CRT 患者的无病生存(DFS)预后根据 TNM 分期分类没有显著差异,但接受短程 CRT 的晚期患者 DFS 较差。淋巴结转移的存在是短程 CRT 中 DFS 不良的预测因素,而病理反应不良是长程 CRT 中复发的预测因素。

结论

对于接受术前 CRT 的直肠癌患者,可能需要根据 CRT 疗程确定不同的复发预测因素,以便从可能从手术后更强化辅助治疗中获益的患者中进行区分。

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