Treatment Interval between Neoadjuvant Chemoradiotherapy and Surgery in Rectal Cancer Patients: A Population-Based Study.
Treatment Interval between Neoadjuvant Chemoradiotherapy and Surgery in Rectal Cancer Patients: A Population-Based Study.
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DOI：
10.1245/s10434-016-5294-0
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发表时间：
2016-10
影响因子：
3.7
通讯作者：
de Wilt JHW
中科院分区：
文献类型：
--
作者：
Rombouts AJM;Hugen N;Elferink MAG;Nagtegaal ID;de Wilt JHW
新辅助放化疗（CRT）已广泛应用于直肠癌患者的治疗中，但新辅助治疗后的最佳手术时机尚不清楚。本研究的目的是评估长疗程CRT与手术间隔时间延长对直肠癌患者的影响。从基于人群的荷兰癌症登记处检索了2006年至2011年间诊断出的所有直肠癌患者的数据；主要结局参数为病理完全缓解（pCR）和总生存期（OS）。早期肿瘤患者（ETs, N = 217）和局部晚期直肠癌患者（LARC, N = 1073）的预后分别报告。根据治疗间隔将患者分为2周间隔组，5-6周至13-14周不等。采用Kaplan-Meier曲线、logistic回归和Cox回归模型进行数据分析。不同治疗间隔ET患者的pCR率无显著差异。与7-8周的治疗间隔相比，9-10周和11-12周的治疗间隔后，LARC患者的pCR率更高（18.4%；比值比[OR] 1.56, 95% CI 1.03-2.37） （20.8%; OR 1.94, 95% CI 1.15-3.26）。治疗间隔对ET或LARC患者的OS无影响。手术和CRT之间的治疗间隔为9-12周，似乎可以提高LARC患者pCR的机会，但对OS没有影响。治疗间隔的长度不影响ET患者的预后。微创手术的持续研究推动了对改善病理反应因素的探索。本文的在线版本（doi:10.1245/s10434-016-5294-0）包含补充材料，可供授权用户使用。
Neoadjuvant chemoradiation therapy (CRT) has been widely implemented in the treatment of rectal cancer patients, but optimal timing of surgery after neoadjuvant therapy is unclear. The purpose of this study was to evaluate the effects of prolonged intervals between long-course CRT and surgery in rectal cancer patients. Data on all rectal cancer patients diagnosed between 2006 and 2011 were retrieved from the population-based Netherlands Cancer Registry; the main outcome parameters were pathologic complete response (pCR) and overall survival (OS). Outcomes were reported separately for patients with early tumors (ETs; N = 217) and locally advanced rectal cancer (LARC; N = 1073). Patients were divided into 2-week interval groups according to treatment interval, ranging from 5–6 to 13–14 weeks. Kaplan–Meier curves, and logistic regression and Cox regression models were used for data analysis. No significant difference in pCR rate was observed for ET patients according to treatment interval. Compared with a treatment interval of 7–8 weeks, pCR rates in LARC patients were higher after 9–10 weeks (18.4 %; odds ratio [OR] 1.56, 95 % CI 1.03–2.37) and 11–12 weeks of treatment interval (20.8 %; OR 1.94, 95 % CI 1.15–3.26). Treatment interval did not influence OS in ET or LARC patients. Treatment intervals of 9–12 weeks between surgery and CRT seem to improve the chances of pCR in LARC patients, without an effect on OS. The length of treatment interval did not affect outcomes in patients with ET. The ongoing search for minimally invasive surgery drives the need for exploration of factors that improve pathologic response. The online version of this article (doi:10.1245/s10434-016-5294-0) contains supplementary material, which is available to authorized users.
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影响因子：
3.7
作者：
Tulchinsky, Hagit;Shmueli, Einat;Rabau, Micha
通讯作者：
Rabau, Micha
影响因子：
3.8
作者：
Bokkerink, G. M. J.;Buijs, E. F. M.;de Wilt, J. H. W.
通讯作者：
de Wilt, J. H. W.
影响因子：
3.7
作者：
Garcia-Aguilar, Julio;Shi, Qian;Posner, Mitchell C.
通讯作者：
Posner, Mitchell C.
DOI：
10.1007/s00432-014-1718-z
发表时间：
2014-10-01
影响因子：
3.6
作者：
Calvo, Felipe A.;Morillo, Virginia;Sole, Claudio
通讯作者：
Sole, Claudio
影响因子：
3.8
作者：
Lefevre JH;Rousseau A;Svrcek M;Parc Y;Simon T;Tiret E;French Research Group of Rectal Cancer Surgery (GRECCAR)
通讯作者：
French Research Group of Rectal Cancer Surgery (GRECCAR)