Correlation in Rectal Cancer Between Clinical Tumor Response After Neoadjuvant Radiotherapy and Sphincter or Organ Preservation: 10-Year Results of the Lyon R 96-02 Randomized Trial
Correlation in Rectal Cancer Between Clinical Tumor Response After Neoadjuvant Radiotherapy and Sphincter or Organ Preservation: 10-Year Results of the Lyon R 96-02 Randomized Trial
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DOI：
10.1016/j.ijrobp.2011.12.002
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发表时间：
2012-06-01
影响因子：
7
通讯作者：
Gerard, Jean Pierre
中科院分区：
文献类型：
--
作者：
Ortholan, Cecile;Romestaing, Pascale;Gerard, Jean Pierre
目的：在直肠癌中，研究新辅助放射剂量递增联合腔内接触放射治疗（CXRT）和外照射放射治疗（EBRT）的获益。本文提供了一个更新的里昂R96-02第三阶段trial.Methods和材料：共88例T2至T3直肠癌患者被随机分配到新辅助EBRT 39戈伊在13个分数（43例）与相同的EBRT与CXRT加强，85戈伊在三个分数（45例）。结果：EBRT组10年累积的永久性结肠造口术（CRPC）率为63%，EBRT+CXRT组为29%（p < 0.001）。10年局部复发率分别为15%和10%（p = 0.69）; 10年无病生存率分别为54%和53%（p = 0.99）; 10年总生存率分别为56%和55%（p = 0.85）。78例患者获得临床缓解（CR）数据（EBRT组36例，EBRT+CXRT组42例）：完全缓解12例（1例患者vs. 11例患者），53例患者的CR >= 50%（24例患者vs. 29例患者），13例患者的CR = 50%，9例患者利用主要CR进行了器官保留手术（意味着没有直肠切除术）。完全CR患者的10年CRPC为17%，CR >= 50%患者为42%，CR患者为77
Purpose: To investigate, in rectal cancer, the benefit of a neoadjuvant radiation dose escalation with endocavitary contact radiotherapy (CXRT) in addition to external beam radiotherapy (EBRT). This article provides an update of the Lyon R96-02 Phase III trial.Methods and Materials: A total of 88 patients with T2 to T3 carcinoma of the lower rectum were randomly assigned to neoadjuvant EBRT 39 Gy in 13 fractions (43 patients) vs. the same EBRT with CXRT boost, 85 Gy in three fractions (45 patients). Median follow-up was 132 months.Results: The 10-year cumulated rate of permanent colostomy (CRPC) was 63% in the EBRT group vs. 29% in the EBRT+CXRT group (p < 0.001). The 10-year rate of local recurrence was 15% vs. 10% (p = 0.69); 10-year disease-free survival was 54% vs. 53% (p = 0.99); and 10-year overall survival was 56% vs. 55% (p = 0.85). Data of clinical response (CR) were available for 78 patients (36 in the EBRT group and 42 in the EBRT+CXRT group): 12 patients were in complete CR (1 patient vs. 11 patients), 53 patients had a CR >= 50% (24 patients vs. 29 patients), and 13 patients had a CR = 50%, 9 had an organ preservation procedure (meaning no rectal resection) taking advantage of major CR. The 10-year CRPC was 17% for patients with complete CR, 42% for patients with CR >= 50%, and 77% for patients with CR