张大奎,王本军,李 明.辅助化疗对ypⅠ期直肠癌患者术后生存的影响[J].肿瘤学杂志,2015,21(1):9-13.
辅助化疗对ypⅠ期直肠癌患者术后生存的影响
Influence of Adjuvant Chemotherapy on Survival in Patients with Rectal Cancer Stage Ⅰ After Neoadjuvant Therapy
投稿时间:2014-09-17  
DOI:10.11735/j.issn.1671-170X.2015.01.B003
中文关键词:  直肠肿瘤  新辅助治疗  降期  预后  外科手术  辅助化疗
英文关键词:rectal neoplasms  neoadjuvant therapy  downstaging  prognosis  surgery  adjuvant chemotherapy
基金项目:
作者单位
张大奎 北京大学肿瘤医院暨北京市肿瘤防治研究所恶性肿瘤发病机制及转化研究教育部重点实验室 
王本军 山东中医药大学附属医院山东省中西医结合肿瘤防治技术重点实验室 
李 明 北京大学肿瘤医院暨北京市肿瘤防治研究所恶性肿瘤发病机制及转化研究教育部重点实验室 
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中文摘要:
      摘 要:[目的] 比较Ⅰ期直肠癌与新辅助治疗后降期为ypT1~2N0M0的cT3~4或N+的直肠癌患者5年总生存率的差异。[方法] 回顾分析105例直肠癌根治术后病理分期为T1~2N0M0的直肠癌患者的临床病理资料及随访资料。按患者是否行新辅助治疗和辅助化疗分为3组。单纯手术组(A组):未经术前新辅助治疗,pT1~2N0M0的早期直肠癌患者(29例)。新辅助降期化疗组(B1组):初始诊断为cT3~4或N+,术前行新辅助治疗后降期为ypT1~2N0M0,且术后行辅助化疗的直肠癌患者(54例)。新辅助降期非化疗组(B2组):初始诊断为cT3~4或N+,术前行新辅助治疗后降期为ypT1~2N0M0,且术后未行辅助化疗的直肠癌患者(22例)。对3组生存情况进行分析。[结果] 新辅助治疗后降期为T1~2N0M0的直肠癌患者(B1+B2组)术后5年生存率为94.0%。单纯手术组(A组)患者术后5年生存率为91.0%,新辅助降期化疗组(B1组)为88.9%,新辅助降期非化疗组(B2组)为90.9%。单因素分析提示3组预后差异无统计学意义(P>0.05)。[结论] 新辅助治疗后降期为T1~2N0M0的直肠癌患者无论是否行术后化疗都可获得与Ⅰ期直肠癌患者相同的预后。新辅助治疗后降期为T1~2N0M0直肠癌患者术后化疗并未能提高患者5年总生存率。
英文摘要:
      Abstract:[Purpose] To compare the 5-year survival between rectal cancer patients with initial stage Ⅰ and stage cT3~4 or N+ patients downstaging to ypT1~2N0M0 after neoadjuvant therapy .[Methods] One hundred and five rectal cancer patients with pathological stage T1~2N0M0 after radical resection were retrospectively analyzed. They were divided into three groups according to with or without neoadjuvant therapy and adjuvant chemotherapy. Group A(n=29): patients with surgery alone ,without neoadjuvant therapy,pT1~2N0M0. Group B1(n=54):initially diagnosed as stage cT3~4 or N+,downstaging to ypT1~2N0M0 after neoadjuvant therapy,and receiving postoperative adjuvant chemotherapy. Group B2(n=22): initially diagnosed as stage cT3~4 or N+,downstaging to ypT1~2N0M0 after neoadjuvant therapy,without postoperative adjuvant chemotherapy. Survivals in 3 groups were analyzed.[Results] The 5-year overall survival rate in patients downstaging to ypT1~2N0M0 after neoadjuvant therapy (group B1+group B2)was 94.0%. And the 5-year overall survival rate was 91.0%,88.9% and 90.9% in group A,group B1 and group B2 respectively. Univariate analysis showed no significant difference of prognosis among the 3 groups.[Conclusion] No matter with or without postoperative adjuvant chemotherapy ,rectal cancer patients downstaging to ypT1~2N0M0 after neoadjuvant therapy might have the similar prognosis to initial stage Ⅰ patients . Patients with neoadjuvant therapy will not benefit from adjuvant chemotherapy.
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