Zhang Chi, Xu Liping, Qin Qin, Liu Jia, Tang Xinyu, Jiang Nan, Zhang Zhaoyue, Li Fei, Cheng Hongyan, Chen Jiayan, Sun Xinchen
Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China.
Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 20032, China.
Transl Cancer Res. 2019 Feb;8(1):150-159. doi: 10.21037/tcr.2019.01.17.
After pre-operative concurrent long course chemoradiotherapy (CRT), pathologic complete response (pCR) has been reported with better oncologic outcomes in many articles, whether a moderate response (TRG1) can translate into good clinical outcome remains uncertain.
A total of 132 locally advanced rectal cancer patients with neoadjuvant chemoradiotherapy followed by radical surgery were recruited. Their clinicopathologic characteristics and clinical records were retrospectively reviewed. The association between clinicopathologic parameters and pathological response was conducted, and the multivariable analysis of the association between pathologic response and survival was performed.
With a median follow-up of 21.5 months, gender was the only factor associated with pCR (TRG0), while dual-agent chemotherapy regimen was linked with a lower likelihood of good response (TRG0-1). Good response (TGR0-1) remained significant associated with overall survival (OS) and disease-free survival (DFS) after multivariate adjustment. TRG1 was linked with better DFS compared with TRG2-3.
Patients with post-CRT good response (TRG0-1) demonstrate an excellent local and remote control, especially with those non-pCR patients (TRG1) getting better outcomes.
在术前进行同步长程放化疗（CRT）后，许多文章报道病理完全缓解（pCR）具有更好的肿瘤学结局，但中度缓解（TRG1）是否能转化为良好的临床结局仍不确定。
共招募了132例接受新辅助放化疗后行根治性手术的局部晚期直肠癌患者。对他们的临床病理特征和临床记录进行回顾性分析。分析临床病理参数与病理反应之间的关联，并对病理反应与生存之间的关联进行多变量分析。
中位随访21.5个月，性别是与pCR（TRG0）相关的唯一因素，而双药化疗方案与良好反应（TRG0-1）的可能性较低相关。多变量调整后，良好反应（TGR0-1）仍与总生存期（OS）和无病生存期（DFS）显著相关。与TRG2-3相比，TRG1与更好的DFS相关。
CRT后反应良好（TRG0-1）的患者表现出出色的局部和远处控制，尤其是那些非pCR患者（TRG1）有更好的结局。
