Analysis of clinical factors related to complete response after neoadjuvant chemoradiotherapy for locally advanced rectal cancer
10.13491/j.issn.1004-714X.2026.01.002
- VernacularTitle:局部晚期直肠癌新辅助放化疗后完全缓解的相关临床因素分析
- Author:
Hui YANG
1
;
Xiaofeng MU
1
;
Linan SONG
1
;
Wenjie NI
1
;
Lei DING
2
Author Information
1. Department of Radio-Oncology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
2. Department of Oncology Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
- Publication Type:OriginalArticles
- Keywords:
Locally advanced rectal cancer;
Neoadjuvant chemoradiotherapy;
Complete response;
Clinical factor
- From:
Chinese Journal of Radiological Health
2026;35(1):6-11
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical factors influencing complete response in patients with locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (nCRT). Methods Clinical data of LARC patients treated in the Department of Radiation Oncology at Beijing Shijitan Hospital between January 2013 and December 2024 were retrospectively collected. All patients received nCRT, after which surgery or a watch-and-wait approach was adopted based on treatment response. Univariable and multivariable logistic regression analyses were performed to identify prognostic factors influencing complete response. A clinical prediction model was constructed based on the multivariable analysis results, and its predictive performance was evaluated using the receiver operating characteristic curve. Results A total of 113 eligible patients were included. After nCRT, 19 patients (16.8%) achieved complete response, including 3 with clinical complete response and 16 with pathological complete response. Univariable analysis indicated that pretreatment clinical N stage, extramural venous invasion, carcinoembryonic antigen level, and neoadjuvant treatment regimen were associated with complete response after nCRT (P<0.05). Multivariable logistic regression analysis identified pretreatment extramural venous invasion, carcinoembryonic antigen level, and neoadjuvant treatment regimen as independent influencing factors for complete response (P<0.05). A prediction model incorporating these independent factors yielded an area under the receiver operating characteristic curve of 0.813 (95% confidence interval: 0.713-0.913), with a sensitivity of 89.5% and a specificity of 60.6%, demonstrating good predictive performance. Conclusion Pretreatment extramural venous invasion, carcinoembryonic antigen level, and neoadjuvant treatment regimen are independent factors influencing complete response after nCRT in LARC patients. The prediction model combining these factors may assist in evaluating treatment efficacy following nCRT in LARC patients.
