局部进展期直肠癌新辅助放化疗后病理完全缓解的预测因素分析

Predictive factor analysis of pathological complete response in patients with locally advanced rectal cancer after neoadjuvant chemoradiotherapy

目的分析影响局部进展期直肠癌新辅助放化疗后病理完全缓解的预测因素。方法局部进展期直肠癌病人88例,所有病人均接受48～50 GY放疗,同期接受氟尿嘧啶为基础的化疗,治疗结束后6～8周接受手术,采用单因素分析及Logistic多因素回归分析法研究病理完全缓解(pCR)的影响因素。结果 10例术后达到pCR,pCR率为11. 4%。单因素分析显示,肿瘤最大径,T分期,N分期,病理类型,治疗前血清癌胚抗原(CEA)水平与肿瘤pCR水平相关。多因素分析显示,N分期和血清CEA水平是影响直肠癌放化疗后pCR的独立因素。结论低N分期和低的血清CEA水平等治疗前临床因素可能是获得pCR的重要因素。

Objective To evaluate the predictive factors associated with pathological complete response after preoperative neoadjuvant chemoradiotherapy for local advanced recta cancer. Methods A retrospective analysis was performed on the clinical data of 88 patients with rectal cancer,who underwent neoadjuvant chemoradiotherapy fellowed by radical surgery,all patients received 48 ～ 50 Gy of radiotherapy,each 2 GY,concurrent fluorouracil-based chemotherapy and then accepted radical surgery after 6 ～ 8 weeks,the clinical factors associated with pCR and non-pCR were analysed by logistic regression. Results Eighty-eight patients were enrolled and 10 patients achieved pCR after operation. The pCR rate was11. 4%. Univariate analysis showed that the maximum tumor diameter,T stage,N stage,pathological type,pre-treatment serum CEA level correlated with tumor pCR level. Multivariate analysis showed that N stage and pre-treatment serum CEA level were the independent predictive factors affecting pCR after neoadjuvant chemoradiotherapy for rectal cancer. Conclusion Pre-treatment clinical factors,such as low N staging and low serum CEA levels,may be associated with pCR after neoadjuvant chemoradiotherapy for rectal cancer.