局部晚期中低位直肠癌术前同期放化疗的预后因素分析

发布时间：2018-04-30 03:05

本文选题：局部晚期直肠癌 + 放射疗法　；参考：《广东医学》2017年02期

【摘要】：目的探讨局部晚期中低位直肠癌术前行同期放化疗的预后因素。方法回顾性分析确诊为局部晚期直肠癌的31例患者的临床资料,所有患者均给予术前同期放化疗+手术,术后行或不行辅助化疗。放疗采用三维适形放疗技术,剂量为46~50.4 Gy/23~28 F;放疗期间同期使用单药卡培他滨或5-氟尿嘧啶(5-FU),或联合方案XELOX、FOLFOX。首要观察终点和次要观察终点分别为总生存率(OS)和无瘤生存率(DFS)。KaplanMeier法计算2年DFS和OS并绘制生存曲线,单因素分析应用双侧Log-rank法检验,多因素预后分析应用Cox回归分析模型。结果全组患者中位随访时间为21个月。8例患者出现肿瘤复发,8例患者死亡(6例死于肿瘤)。全组2年DFS和2年OS分别为80.6%和60.9%。全组患者保肛率为48.3%,术后病理完全缓解率(p CR)为12.9%。单因素分析提示,术后病理分期和降级是DFS的重要影响因素,手术方式、术后病理分期、是否降级是OS的重要影响因素;多因素分析提示,术后病理分期是DFS和OS的独立影响因素。结论术后病理分期是局部晚期中低位直肠癌术前行同期放化疗的独立预后因素。
[Abstract]:Objective to investigate the prognostic factors of local advanced middle-low rectal cancer. Methods the clinical data of 31 patients with locally advanced rectal cancer were retrospectively analyzed. Three-dimensional conformal radiotherapy was performed at a dose of 46V 50.4 Gy/23~28 / F, and a single drug capecitabine or 5-FUU, or a combined regimen of Xerox and FOLFOX, was used during the same period of radiotherapy. The primary and secondary endpoints were the overall survival rate (OS) and the tumor-free survival rate. The 2-year DFS and OS were calculated and the survival curves were plotted by DFS- .Kaplan Meier method. The univariate analysis was tested by bilateral Log-rank method, and the Cox regression model was used for multivariate prognostic analysis. Results the median follow-up time of the whole group was 21 months. 8 patients died of tumor recurrence and 6 patients died of cancer. The 2 year DFS and 2 year OS in the whole group were 80.6% and 60.9%, respectively. The rate of anal preservation was 48.3%, and the complete remission rate of postoperative pathology was 12.9%. Univariate analysis showed that postoperative pathological staging and demotion were important influencing factors of DFS. Postoperative pathological staging is an independent factor of DFS and OS. Conclusion postoperative pathological staging is an independent prognostic factor of preoperative radiotherapy and chemotherapy for local advanced middle-low rectal cancer.
【作者单位】：东莞市人民医院放疗科;
【分类号】：R735.37;R730.55

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