| 陶金华,王贵玉,马德宁.直肠癌患者新辅助同步放化疗后病理完全缓解的影响因素分析[J].肿瘤学杂志,2021,27(8):643-648. |
| 直肠癌患者新辅助同步放化疗后病理完全缓解的影响因素分析 |
| Analysis of Influencing Factors of Pathological Complete Remission After Neoadjuvant Concurrent Chemoradiotherapy in Rectal Cancer Patients |
| 投稿时间：2021-07-25 |
| DOI：10.11735/j.issn.1671-170X.2021.08.B007 |
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| 中文关键词: 直肠肿瘤 新辅助同步放化疗 病理完全缓解 预后 |
| 英文关键词:rectal neoplasms neoadjuvant chemoradiotherapy pathologic complete response prognosis |
| 基金项目:浙江省医药卫生科技计划项目（2021KY104） |
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| 中文摘要: |
| 摘 要：［目的］ 探讨直肠癌新辅助放化疗（nCRT）后pCR的预测因素，并分析pCR对术后并发症的影响。［方法］ 回顾性分析中国科学院大学附属肿瘤医院2008—2016年收治的接受新辅助治疗并进行根治性手术切除直肠癌患者456例。依据术后病理将患者分为pCR组和非pCR组。单因素和多因素分析pCR的影响因素，并分析两组术后并发症情况。［结果］ 456例患者中，98例（21.4％）达到pCR，pCR组和非pCR组患者在年龄、性别、肿瘤分化、临床T和N期、手术类型、放疗剂量和术后并发症方面无明显差异，与pCR相关的因素包括肿瘤大小、治疗前CEA水平、放疗剂量以及手术间隔时间超过8周；多因素分析结果显示，治疗前CEA水平（OR=0.440，95％CI：0.254～0.837，P=0.017）和手术间隔时间（OR=2.641，95％CI：1.385～5.104，P=0.003）是pCR的独立预测因素。［结论］ 治疗前CEA水平和手术间隔时间与nCRT 后pCR率有关，pCR不增加术后并发症的发生风险。 |
| 英文摘要: |
| Abstract： ［Objective］ To investigate the predictive factors of pathologic complete response(pCR) after neoadjuvant chemoradiotherapy(nCRT) for patients with rectal cancer， and to analyze the effect of pCR on postoperative complications.［Methods］ A total of 456 patients from The Cancer Hospital of the University of Chinese Academy of Sciences（Zhejiang Cancer Hospital） who had clinical stage Ⅱ/Ⅲ rectal cancer and underwent a long-course neoadjuvant CRT， followed by curative surgery from 2008 to 2016 were included. Patients were divided into two groups according to their responses to neoadjuvant therapy： the pCR and non-pCR groups. The clinical parameters were analyzed by univariate and multivariate analyses， with pCR as the dependent variable. And the postoperative complications were analyzed between the two groups. ［Results］ Of the 456 patients， 98(21.4%) achieved pCR. There was no significant difference in age， gender， tumor differentiation， clinical T and N stages， surgery type， radiotherapy dose and postoperative complications between pCR group and non pCR group. The factors related to pCR included tumor size， pretreatment CEA level， radiotherapy dose and the operation interval was more than 8 weeks. Multivariate analysis showed that CEA level before treatment(OR=0.440， 95%CI：0.254~0.837， P=0.017) and operation interval(OR=2.641， 95%CI：1.385~5.104， P=0.003) were independent predictors of pCR. ［Conclusion］ CEA level before treatment and operation interval are related to pCR rate after nCRT， pCR is not associated with an increased risk of major postoperative complications. |
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