Facondo Giuseppe, Belotti Federico, Rotondi Margherita, Vullo Gianluca, Fiorelli Silvia, Mossa Stefano, De Sanctis Vitaliana, Osti Mattia Falchetto
Department of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, Radiotherapy Oncology, St. Andrea Hospital, 00189, Rome, Italy.
Discov Oncol. 2024 Nov 12;15(1):645. doi: 10.1007/s12672-024-01529-5.
To evaluate efficacy and tolerance of short-course radiotherapy (SCRT) prior to possible chemotherapy (CHT) and surgery in 64 patients with locally advanced rectal cancer, in terms of acute and early late toxicity and survival outcomes with prognostic factors.
Sixty-four patients affected by rectal tumor were treated from 2008 to 2023 radiation therapy, with a total dose of 25 Gy in 5 fractions. The Kaplan-Meier method was used to estimate the rates of overall survival (OS), cancer specific survival (CSS), local control (LC), disease free survival (DFS) and metastasis free survival (MFS). Univariate analysis for prognostic factors was performed with the log-rank test, and Cox proportional hazards regression was used to estimate hazard ratios. Toxicity assessment has been considered in acute and in early late for gastrointestinal (GI), genitourinary (GU) districts.
Median follow-up was 49.6 months. The median OS was 65 months with 1-year, 2-year and 5-year OS at 90.6%, 77.7% and 60% respectively. CSS at the 1-year, 2-year and 5-year was 98.3%, 96.2% and 86.2% respectively. LC at 1-year, 2-year and 5-year was 93.4%, 89.4% and 87.2% respectively. DFS at the 1-year, 2-year and 5-year was 93.4%, 89% and 87% respectively. The status of lymph nodes at diagnosis was a prognostic factor in term of LC and DFS. Acute GI toxicity was G1 in 10 (15.6%) patients. Five (7.8%) patients had a G1 acute GU toxicity. Fifteen (23.4%) patients developed chronic GI toxicities.
SCRT is an effective treatment in patients with rectal cancer and provides good outcomes with very low rates of toxicity profile.
评估64例局部晚期直肠癌患者在可能进行化疗（CHT）和手术之前接受短程放疗（SCRT）的疗效和耐受性，包括急性和早期晚期毒性以及生存结果和预后因素。
2008年至2023年期间，对64例直肠肿瘤患者进行放射治疗，总剂量为25 Gy，分5次给予。采用Kaplan-Meier方法估计总生存（OS）率、癌症特异性生存（CSS）率、局部控制（LC）率、无病生存（DFS）率和无转移生存（MFS）率。采用对数秩检验对预后因素进行单因素分析，并使用Cox比例风险回归估计风险比。对胃肠道（GI）、泌尿生殖系统（GU）区域的急性和早期晚期毒性进行了评估。
中位随访时间为49.6个月。中位OS为65个月，1年、2年和5年OS分别为90.6%、77.7%和60%。1年、2年和5年的CSS分别为98.3%、96.2%和86.2%。1年、2年和5年的LC分别为93.4%、89.4%和87.2%。1年、2年和5年的DFS分别为93.4%、89%和87%。诊断时的淋巴结状态是LC和DFS方面的预后因素。10例（15.6%）患者出现急性GI毒性，为1级。5例（7.8%）患者出现1级急性GU毒性。15例（23.4%）患者出现慢性GI毒性。
SCRT是直肠癌患者的一种有效治疗方法，毒性发生率极低，疗效良好。
