- 期刊
Impact of Pre-Operative Chemoradiotherapy on cT3N0M0 Middle and Low Rectal Cancer
術前合併化學與放射治療對臨床上第二期初期直腸癌的影響
摘要
目的 評估術前合併化學與放射治療對臨床上第二期初期直腸癌的影響。方法 本研究收集自2000年7月至2004年12月共103位罹患臨床上第二期初期直腸癌的病人資料。其中37位病人術前接受核磁共振造影評估腫瘤臨床分期，而另外66位病人則接受電腦斷層造影評估之。所有病人中，23位接受術前合併化學與放射治療，而另外80位則否。廣泛性手術切除依照準則而行。最後的分析結果包括存活率、局部復發率以及遠端轉移率。結果 在接受術前合併化學與放射治療的病人族群中，其病理上完全反應率為34.8%，而降低腫瘤分期率為73.9%。存活率在兩組病人群中並無顯著差異（全部病人存活率：91.3% vs. 82.1%；無疾病存活率：86.4% vs. 79.5%；惡性腫瘤相關存活率：91.3 vs. 91.0%）。在局部復發及遠端轉移的控制上也無明顯差異存在。結論 對於罹患臨床上第二期初期直腸癌的病人而言，術前合併化學與放射治療可能沒有提供更好的局部疾病復發控制及存活率。
並列摘要
Purpose. To evaluate the oncological benefit of neoadjuvant concurrent Chemo-RadioTherapy (CCRT) for cT3N0M0 rectal cancer.Materials and Method. Between July 2000, and December 2004, 103 patients of middle and low rectal cancer with primary cT3N0M0 were enrolled. Of them, 37 patients were staged by magnetic resonance imaging (MRI), and 66 by computed tomography (CT); 80 patients did not receive pre-operative concurrent Chemo-RadioTherapy (CCRT) and 23 did. Radical resections were performed as the protocol. The oncological results including survival, local and distant metastasis rates were analyzed.Results. For the concurrent Chemo-RadioTherapy (CCRT) group, the complete response rate was 34.8% and the down staging rate was 73.9%. There was no significant difference in survival analysis between the two groups (OS: 91.3% vs. 82.1%; DFS: 86.4% vs. 79.5%; CSS: 91.3% vs. 91.0%), neither in local (10% vs. 4.3%) nor distant control (23.8% vs. 17.4%).Conclusion. Pre-operative concurrent Chemo-RadioTherapy (CCRT) might not provide better local control or survival benefit for cT3N0M0 middle and low rectal cancer.