PREDICTIVE FACTORS OF TUMOR RESPONSE AFTER NEOADJUVANT CHEMORADIATION FOR LOCALLY ADVANCED RECTAL CANCER
PREDICTIVE FACTORS OF TUMOR RESPONSE AFTER NEOADJUVANT CHEMORADIATION FOR LOCALLY ADVANCED RECTAL CANCER
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DOI：
10.1016/j.ijrobp.2010.02.025
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发表时间：
2011-06-01
影响因子：
7
通讯作者：
Salem, Naji
中科院分区：
文献类型：
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作者：
Moureau-Zabotto, Laurence;Farnault, Bertrand;Salem, Naji
目的：手术后新辅助放化疗是局部进展期直肠癌的标准治疗。本研究的目的是相关的肿瘤反应生存和确定肿瘤反应的预测因素后chemoradiation.Methods和材料：从1998年至2008年，168例经组织学证实的局部晚期腺癌术前chemoradiation治疗全直肠系膜切除术进行了回顾性研究。他们接受了45戈伊的放射剂量，同时接受了基于5-氟尿嘧啶（5-FU）的化疗。肿瘤缓解分析基于治疗前直肠内超声和病理标本之间T分期的降低。总体和无进展生存率与肿瘤缓解相关。结果：中位随访时间为34个月。5年无病生存率和总生存率在整个人群中分别为44.4%和74.5%，在病理完全缓解患者中分别为83.4%和83.4%，在肿瘤降级患者中分别为38.6%和71.9%，在无缓解患者中分别为29.1%和58.9%。治疗前癌胚抗原（CEA）水平为
Purpose: Neoadjuvant chemoradiation followed by surgery is the standard of care for locally advanced rectal cancer. The aim of this study was to correlate tumor response to survival and to identify predictive factors for tumor response after chemoradiation.Methods and Materials: From 1998 to 2008, 168 patients with histologically proven locally advanced adenocarcinoma treated by preoperative chemoradiation before total mesorectal excision were retrospectively studied. They received a radiation dose of 45 Gy with a concomitant 5-fluorouracil (5-FU)-based chemotherapy. Analysis of tumor response was based on lowering of the T stage between pretreatment endorectal ultrasound and pathologic specimens. Overall and progression-free survival rates were correlated with tumor response. Tumor response was analyzed with predictive factors.Results: The median follow-up was 34 months. Five-year disease-free survival and overall survival rates were, of 44.4% and 74.5% in the whole population, 83.4% and 83.4%, respectively, in patients with pathological complete response, 38.6% and 71.9%, respectively, in patients with tumor downstaging, and 29.1 and 58.9% respectively, in patients with absence of response. A pretreatment carcinoembryonic antigen (CEA) level of