直腸癌病人接受術後單獨放射線治療之治療結果及預後因子

Adjuvant Postoperative Radiotherapy of Rectal Cancer: An Analysts of Treatment Results and Prognostic Factors

許軒之(Hsuan-Chih Hsu) ； 陳鴻華(Hong-Hwa Chen) ； 王重榮(Chong-Jong Wang) ； 黃英彥(Eng-Yen Huang) ； 張家駱(Chia-Lo Chang) ； 熊敬業(Ching-Yeh Hsiung) ； 陳惠君(Hui-Chun Chen)

《放射治療與腫瘤學》 6卷3期 (1999/09) Pp. 179-186

https://doi.org/10.6316/TRO/199906(3)179

摘要

Purpose: To analyze the treatment results and prognostic factors in rectal cancer patients receiving postoperative radiotherapy after radical resection.
Materials and Methods: From October 1987 through August 1997, ninety-five patients with stage II or III (AJCC1997) rectal cancer were treated with complete surgical resection and postoperative adjuvant pelvic irradiation without chemotherapy. The radiation was delivered with 10 or 15 MV X-ray given 5 days per week at 1.8 to 2Gy per fraction. Total doses ranged from 52 to 60Gy. All patients had at least 2 years of follow-up.
Results: The 5-year local control rate (LC), overall survival rate (OS), distant metastasis-free rate (DMF) and disease-free survival rate (DFS) for the 95 patients were 49%, 43%, 46% and 35%, respectively. In univariate analysis, the stage (Ⅱ vs. Ⅲ), T stage (T3 vs. T4), N stage (N0 vs. N1 vs. N2) and preoperative CEA (＜5 vs. ≥5ng/ml) were the significant prognostic factors in LC, OS, DMF and DFS. In multivariate analysis, the N stage was the only statistically significant predictor of LC (p=0.0124), OS (p=0.0014), DMF (p=0.0012) and DFS (p=0.0010).
Conclusion: N stage (the number of involved nodes) is the most important prognostic factor in rectal cancer patients receiving postoperative radiotherapy alone. Patients with more than 3 involved nodes had significantly poor treatment outcome. The optimal adjuvant treatment for rectal cancer is still controversial. Further investigation of various treatment modalities is needed.

關鍵字

直腸癌 ； 手術後放射線治療 ； 放射線治療

並列摘要

Purpose: To analyze the treatment results and prognostic factors in rectal cancer patients receiving postoperative radiotherapy after radical resection.
Materials and Methods: From October 1987 through August 1997, ninety-five patients with stage II or III (AJCC1997) rectal cancer were treated with complete surgical resection and postoperative adjuvant pelvic irradiation without chemotherapy. The radiation was delivered with 10 or 15 MV X-ray given 5 days per week at 1.8 to 2Gy per fraction. Total doses ranged from 52 to 60Gy. All patients had at least 2 years of follow-up.
Results: The 5-year local control rate (LC), overall survival rate (OS), distant metastasis-free rate (DMF) and disease-free survival rate (DFS) for the 95 patients were 49%, 43%, 46% and 35%, respectively. In univariate analysis, the stage (Ⅱ vs. Ⅲ), T stage (T3 vs. T4), N stage (N0 vs. N1 vs. N2) and preoperative CEA (＜5 vs. ≥5ng/ml) were the significant prognostic factors in LC, OS, DMF and DFS. In multivariate analysis, the N stage was the only statistically significant predictor of LC (p=0.0124), OS (p=0.0014), DMF (p=0.0012) and DFS (p=0.0010).
Conclusion: N stage (the number of involved nodes) is the most important prognostic factor in rectal cancer patients receiving postoperative radiotherapy alone. Patients with more than 3 involved nodes had significantly poor treatment outcome. The optimal adjuvant treatment for rectal cancer is still controversial. Further investigation of various treatment modalities is needed.

並列關鍵字

Rectal cancer ； Postoperative radiotherapy ； Irradiation