The clinical efficacy of neoadjuvant chemoradiotherapy combined with radical resection for advanced rectal cancer
10.3760/cma.j.issn.1673-4904.2013.17.004
- VernacularTitle:新辅助放化疗联合直肠癌根治术治疗中晚期直肠癌的临床疗效观察
- Author:
Xuechao JIANG
;
Daoquan ZHANG
- Publication Type:Journal Article
- Keywords:
Rectal neoplasms;
Radiotherapy;
Neoadjuvant chemotherapy
- From:
Chinese Journal of Postgraduates of Medicine
2013;36(17):10-14
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical efficacy of neoadjuvant chemo radiotherapy combined with surgical treatment for advanced rectal cancer.Methods Fifty-one patients with advanced rectal cancer were randomly divided into treatment group and control group by random number table.In treatment group,26 cases received three-dimensional conformal radiotherapy synchronization XELOX chemotherapy for 2 cycles,then they received radical resection after 4-6 weeks.Twenty-five cases in control group received neoadjuvant chemotherapy with XELOX for 2 cycles,then received radical resection.Results The objective response rate in treatment group was 84.6% (22/26),and in control group was 60.0%(15/25),there was significant difference between two groups (P =0.049).Radical resection in treatment group was 96.2% (25/26),significantly higher than that in control group 76.0% (19/25)(P =0.037).The sphincter preservation rate in treatment group was 61.5% (16/26),and in control group was 20.0% (5/25),there was significant difference between two groups (P =0.003).The pathologic complete response rate in treatment group was 26.9% (7/26),significantly higher than that in control group 4.0% (1/25)(P =0.024).The 1,2 and 3 year survival rate in treatment group were 88.0%(22/25),60.0%(15/25),32.0%(8/25),which were significantly higher than those in control group 62.5% (15/24),29.2% (7/24),8.3% (2/24) (P =0.038,0.030,0.040).The 1,2,and 3 year recurrence rate in treatment group were 8.0%(2/25),20.0%(5/25),36.0% (9/25),which were significantly lower than those in control group 33.3% (8/24),44.8%(12/24),66.7% (16/24) (P=0.028,0.027,0.032).Conclusion Neoadjuvant chemoradiotherapy can improve the rate of surgical resection,sphincter preservation and prolong survival of rectal cancer,it can be used as a kind of effective treatment for rectal cancer.