Preperative Radiotherapy Concurrent with Chemotherpy for Locally Advaced Rectal Cancer

直腸癌接受術前同步化學合併放射治療

陳玉瑄(Yu-Xuan Chen) ； 陳自諒(WilliamChen) ； 劉幕台(Mu-Tai Liu) ； 鐘智淵(Chih-Yuang Chung) ； 張正雄(Cheng-Shyong Chang) ； 許格豪(Ger-Hau Hsu) ； 陳宏彰(Hong-Chang Chen) ； 張東浩(Tung-Hao Chang) ； 畢祖平(Chu-Ping Pi) ； 許智捷(Chih-Chiech Hsu)

《放射治療與腫瘤學》 10卷1期 (2003/03) Pp. 19-26

https://doi.org/10.6316/TRO/200310(1)19

摘要

”目地：分析局部侵犯性直腸癌病人接受術前同步化學及放射線治療， 對腫瘤期別下降和肛門保留的幫助。
材料與方法：在1999年6月到2002年2月間，本院共有22名直腸癌病人接受術前同步化學及放射線治療，再行手術切除。其中包括16位男性和6位女性，年齡分佈從28到76歲，年齡中位數61歲。化學治療使用高劑量5-Fluorouracil(5-FU)合併Leucovorin；放射治療中位劑量為50AGy (45Gy - 50AGy)針對骨盆腔。放射治療結束後平均6週(1至11.7週)接受治癌性手術。比較手術後病理期別和治療前臨床觀別之間的差異，及肛門保留在這些病人的比例。
結果：22位病人中有12位(55%)有期別下降，其中有三位（14%）的得到完全緩解，在切下組織標本中沒有殘存的腫瘤細胞。另外5位則是病理期別和臨床期別一樣。還有兩位則是治療前評估為Nl，但病理期別顯示N2。有18位(82%)病人施行肛門保留性手冊。
結論：術前同步化學及放射線治療再加上手術能有效使腫瘤期別下降， 並能使大部分局部晚期直腸癌病人保留肛門。 ”

關鍵字

直腸癌,術前化學放射治療

並列摘要

”Purpose: This study is to present the rates of tumor down-staging and sphincter-preservation with pre-operative concurrent chemo-radiation therapy (CCRT) in locally advanced rectal cancer
Methods and Materials: Between June1999 and February 2002, twenty-two patients with advanced rectal cancer were treated with preoperative CCRT, followed by surgical resection of disease, The patient population consisted of 16 males and 6 females that had a median age of 61 year (range 28 to 76 years). Most of patients received high dose 5-Fluorouracil (5-FU) and Leucovorin, concurrent with pelvic irradiation 50.40Gy(45-50.4 Gy) in 28 fractions over 5.5 weeks. The median interval between completion of radiotherapy and surgery was 6 weeks (range 1-11.7 weeks). The retreatment and post-treatment stages were compared and rates of sphincter preservation were evaluated.
Results: Twelve (55%) out of 22 patients achieved tumor downstaging, and 3 (14%) patients had pathologic complete remission. Five patients remained the same stage as pretreatment clinical stage. Two patients had clinical N1 disease but pathologic N2 stage. Sphincter- preserving surgery can achieve in 18(82%) patients.
Conclusion: Pre-operative CCRT followed by surgery can be effective for tumor shrink-age, tumor downstaging, and achieving sphincter preservation in most of patients.”

並列關鍵字

Rectal cancer, Preoperative chemoradiation