Clinical efficacy of ladder neoadjuvant therapy in treatment of advanced mid-low rectal cancer
10.3760/cma.j.issn.0253-3766.2017.07.012
- VernacularTitle: 阶梯式新辅助治疗在中低位进展期直肠癌中的临床应用价值
- Author:
Yixun ZHANG
1
;
Haibo WANG
1
;
Yanjun LU
1
;
Haiyi LIU
1
Author Information
1. Department of the Colorectal and Anal Surgery, Shanxi Cancer Hospital, Taiyuan 030013, China
- Publication Type:Clinical Trail
- Keywords:
Rectal neoplasms;
Treatment efficacy;
Prognosis;
Ladder neoadjuvant therapy
- From:
Chinese Journal of Oncology
2017;39(7):536-539
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical efficacy of ladder neoadjuvant therapy in treatment of advanced mid-low rectal cancer.
Methods:We performed a retrospective study of one hundred and eighty mid and low rectal cancer patients who underwent ladder neoadjuvant therapy(neoadjuvant chemotherapy followed by surgery if neoadjuvant chemotherapy was effective; neoadjuvant chemotherapy followed by neoadjuvant chemoradiotherapy if neoadjuvant chemotherapy was ineffective)(n=90) or neoadjuvant chemoradiotherapy (n=90).
Results:In the ladder neoadjuvant therapy group, the descent stage rate was 85.6% (77/90), the anastomosis rate was 50.0% (45/90), the pre-sacral infection rate was 4.4% (4/90), the pathological complete remission (pCR) was 13.3%(12/90), R0 resection rate was 85.6% (77/90), the 2-year disease control rate was 76.7% (69/90), and the 2-year survival rate was 90.0% (81/90). In the control group, the descent stage rate was 88.9% (80/90), The anastomosis rate was 45.6% (41/90), the rate of pre-sacral infection was 11.1% (10/90), pCR was 16.7% 15/90), R0 resection rate was 88.9% (80/90), the 2-year disease control rate was 78.9% (71/90), and the 2-year survival rate was 87.8% (79/90). The difference was not statistically significant (P>0.05). The ladder neoadjuvant therapy group had lower prophylactic transverse colostomyrate(10.0% vs 34.4%), lower radiation injury rate (6.7% vs 27.8%), and lower sexual dysfunction rate (38.9% vs 87.8)compared to the control group.
Conclusions:The ladder neoadjuvant therapy might reduce side injury caused by radiotherapy, improve compliance of patients, and reduce treatment costs. Moreover, the RO resection rate, 2-year local control rate and 2-year survival rate of ladder neoadjuvant therapy group was comparable with neoadjuvant chemoradiotherapy.
