Ⅱ~Ⅲ期直肠癌新辅助同期放化疗116例疗效分析

Analysis of the efficacy of neoadjuvant chemoradiation for the treatment of Ⅱ-Ⅲ stage rectal cancer of 116 cases

目的探讨Ⅱ~Ⅲ期(局部晚期)直肠癌新辅助放化疗后疗效及预后。方法回顾性分析116例经影像学及病理证实的Ⅱ~Ⅲ期直肠癌患者临床资料,所有患者均在行术前接受同期放化疗。收集完整影像及临床资料,记录肿瘤临床分期、区域淋巴转移、EMVI、CEA、肿瘤占直肠周长比、肿瘤部位、放化疗后疗效及化疗方案等。分析上述因素对无病生存率(DFS)及总生存率(OS)预后影响。结果全组中位无病进展时间及生存时间分别为53个月和64个月,5年DFS及OS分别为57.7%和62.1%。单因素分析显示EMVI、肿瘤部位、肿瘤占直肠周长比、放化疗后PCR是DFS的影响因素(P<0.05);上述因素同样亦是OS的影响因素(P<0.05)。多因素分析结果显示EMVI、肿瘤部位、肿瘤占直肠周长比、放化疗后PCR均是DFS及OS的独立影响因素(P<0.05)。结论 EMVI阳性、肿瘤部位低位、肿瘤占直肠周长比大于1/2及放化疗后未达到PCR是影响预后的不利因素。

Objective To explore the efficacy ofⅡ-Ⅲstage(locally advanced)rectal cancer after neoadjuvant chemoradiation.Methods Authors retrospectively evaluated the data of 116 patients with confirmed by radiographic and pathologic fondingsⅡ-Ⅲstage rectal cancer.The all patients received preoperative radiation and chemotherapy.Integrated images and clinical information were collected,including clinical stage,regional lymph node metastasis,EMVI,CEA level,the ratio of tumor in rectum circumference rate,tumor site,curative effect after radiation and chemotherapy,and analyzed the relationship between the above factors and disease free survival(DFS)rates and overall survival(OS)rates.Results The whole patient's median disease free progress and survival time were 53 months and 64 months respectively,5 years-DFS and OS were 57.7%and 62.1%respectively.Mon-variate analysis showed that EMVI,tumor site,the ratio of tumor in rectum circumference,curative effect after radiation and chemotherapy were influence factors for DFS(P<0.05);As the same as OS.Multivariate analysis found EMVI,tumor site,the ratio of tumor in rectum circumference,curative effect after radiation and chemotherapy radiation were independent factors for DFS and OS(P<0.05).Conclusion EMVI positive,tumor site,the ratio of tumor in low rectal circumference greater than 1/2,and not reached the PCR after radiation and chemotherapy are unfavorable factors affecting patient's prognosis.