Reed W P, Garb J L, Stark A J, Chabot J R, Friedmann P
Department of Surgery, Baystate Medical Center Campus, Tufts University School of Medicine, Springfield, Massachusetts, USA.
Chirurg. 1996 Jun;67(6):621-4.
We have previously reported improvements in survival and disease-free survival at five years using preoperative radiation in the treatment of rectal cancer. The current update was undertaken to determine if these favorable results were durable with longer follow-up.
Patients found to have resectable rectal cancer between 1972 and 1979 were treated with 40-45 Gy of preoperative radiation (40 patients) or resection alone (109 patients). Follow-up information beyond five years was obtained from the Tumor Registry, physician contact and a survey of the National Death Index. Of the 149 patients followed for five years, 144 were evaluable at ten years.
After a median follow-up of 125 months, survival of the irradiated patients was significantly better than that of controls (77 versus 57% at 5 years and 74 versus 41% at 10 years, p = 0.0044). Disease-free survival of those patients whose resection margins were free was also superior for the irradiated group (85 versus 59% at 5 years and 80 versus 45% at 10 years, p = 0.0045).
The results show that the survival advantage for 40 to 45 Gy preoperative radiation in the treatment of rectal cancer persist at 10 years follow-up.
我们之前报道过，术前放疗用于直肠癌治疗可使患者五年生存率和无病生存率得到改善。此次更新旨在确定随着随访时间延长，这些良好结果是否持久。
1972年至1979年间确诊为可切除直肠癌的患者，一部分接受40 - 45 Gy术前放疗（40例患者），另一部分仅接受手术切除（109例患者）。五年后的随访信息通过肿瘤登记处、与医生联系以及对国家死亡指数的调查获取。在149例接受五年随访的患者中，144例在十年时可进行评估。
中位随访125个月后，接受放疗患者的生存率显著高于对照组（5年时分别为77%和57%，10年时分别为74%和41%，p = 0.0044）。切缘阴性患者的无病生存率同样是放疗组更高（5年时分别为85%和59%，10年时分别为80%和45%，p = 0.0045）。
结果表明，术前40至45 Gy放疗治疗直肠癌的生存优势在十年随访时依然存在。
