局部进展期中低位直肠癌新辅助治疗后病理消退影响因素分析

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Abstract Objective: To analyze the influencing factors of good pathological tumor regression grades after neoadjuvant chemoradiotherapy (CRT) in locally advanced rectal cancer (LARC) and evaluate the value of standardized concurrent preoperative CRT in improving the clinical efficacy in LARC. Methods: A total of 122 patients with LARC receiving neoadjuvant CRT between January 2002 and December 2009 were analyized retrospectively. The tumor regression grades (TRG) were detected by HE staining. Logistic regression analysis was used to evaluate the influencing factors associated with clinical efficacy after neoadjuvant CRT in LARC. Results: Fifty-two patients reached good TRG, including 11 patients with pathological complete response, 70 patients were poorly responsive to radiation. The good response rate after long-course radiation therapy (RT) was significantly higher than that of patients who underwent short/medium course RT (60% vs 30.56%, P=0.005), the good response rate with concurrent preoperative CRT was significantly higher than that of patients with preoperative RT alone (54.05% vs 25%, P=0.002), the good response rate after RT dose>4 000 cGy was significantly higher than that of patients underwent RT dose≤4 000 cGy (60.42% vs 31.08%, P=0.001). Logistic regression analysis showed the concurrent preoperaticve CRT and long-course RT were independently associated with the clinical efficacy in LARC after neoadjuvant CRT. The rate of patients received concurrent preoperative CRT, long-course RT, RT dose>4 000 cGy and the interval between neoadjuvant CRT and surgery≥6 weeks between January 2006 and December 2009 was significantly higher than that of patients between January 2002 and December 2005 (71.43% vs 51.51%, 57.14% vs 27.27%, 48.21% vs 30.30%, 50.0% vs 28.79%). Conclusion:Concurrent preoperative CRT and long-course RT provide higher good response rate, standardized preoperative concurrent CRT may improve the clinical efficacy in patients with LACR.

Key words： rectal neoplasm tumor regression grades neoadjuvant chemoradiotherapy clinical influencing factors

Received: 28 October 2013

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	ZUO Zhigui1
	WANG Hao2
	GAO Xianhua2
	YU Zhiqi2
	DOU Weilong2
	FU Chuangang2
	SONG Huayu1
	LI Ji1.

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2014/V44/I4/235

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