Enhanced tumorocidal effect of chemotherapy with preoperative radiotherapy for rectal cancer: Preliminary results - EORTC 22921
Enhanced tumorocidal effect of chemotherapy with preoperative radiotherapy for rectal cancer: Preliminary results - EORTC 22921
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DOI：
10.1200/jco.2005.02.113
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发表时间：
2005-08-20
影响因子：
45.3
通讯作者：
Collette, L
中科院分区：
文献类型：
--
作者：
Bosset, JF;Calais, G;Collette, L
目的欧洲癌症研究与治疗组织（EORTC）的一项临床试验评价了术前放疗（preop RT）基础上加用化疗（CT）和术后CT对提高T3-4可切除直肠癌患者生存率的价值。患者被分配到以下4组：第1组，术前RT 45戈伊，共5周;第2组，术前RT加两个5天的CT疗程（氟尿嘧啶350 mg/m2/d和亚叶酸20 mg/m2/d），分别在RT的第1周和第5周;第3组，术前RT加4个术后CT疗程;第4组，术前RT和CT加术后CT。我们研究了增加CT对病理参数的影响。患者和方法1011例患者进入试验; 505例接受术前RT（第1和3组），506例接受术前RT-CT（第2和4组）。我们分析了肿瘤大小、肿瘤淋巴结分期、回收淋巴结数量、组织学特征如淋巴、静脉和神经周围浸润、肿瘤分化程度和肿瘤类型的差异。
Purpose The European Organisation for Research and Treatment of Cancer (EORTC) trial evaluated the addition of chemotherapy (CT) to preoperative radiation (preop RT) and the value of postoperative CT for improving the survival in patients with T3-4 resectable rectal cancer. Patients were allocated to the following four arms: arm 1, preop RT 45 Gy in 5 weeks; arm 2, preop RT plus two 5-day CT courses (fluorouracil 350 mg/m(2)/d and leucovorin 20 mg/m(2)/d) in the first and fifth week of RT; arm 3, preop RT plus four postoperative CT courses; and arm 4, preop RT and CT plus postoperative CT. We investigated the effect of adding CT on the pathologic parameters.Patients and Methods One thousand eleven patients were entered onto the trial; 505 received preop RT (arms 1 and 3), and 506 received preop RT-CT (arms 2 and 4). We analyzed the differences in tumor size, tumor node stage, number of retrieved nodes, and histologic features such as lymphatic, venous, and perineural invasions, tumor differentiation, and tumor type.Results After preop RT-CT, tumors were smaller (P