直肠癌新辅助放化疗后的等待时间:真的重要吗?

IF 0.8 Q4 GASTROENTEROLOGY & HEPATOLOGY Gastrointestinal Tumors Pub Date : 2018-02-01 Epub Date: 2017-12-15 DOI:10.1159/000484982
Aris Plastiras, Michail Sideris, Andy Gaya, Amyn Haji, Joseph Nunoo-Mensah, Asif Haq, Savvas Papagrigoriadis
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引用次数: 7

摘要

背景:新辅助放化疗(CRT)被认为是任何局部晚期直肠肿瘤手术干预前的标准方法,已被证明可显著提高直肠癌的局部复发率。然而,新辅助CRT后手术切除的最佳时机仍有争议。目的和方法:我们对连续65例局部晚期直肠癌患者进行术前CRT和手术切除的回顾性分析,以评估手术治疗的最佳时机。我们选择了两组进行分析:在CRT后6周内接受手术的患者(n = 28)和在CRT后6周或更长时间接受手术的患者(n = 27)。此外,我们还比较了3个月内手术的患者(n = 39)和3个月以上手术切除的患者(n = 16)。对CRT无反应者被排除在分析之外。结果:各组患者CRT后等待时间与放疗降期无统计学意义(p > 0.05)。此外,疾病复发、癌症相关死亡、神经周围浸润或淋巴结阳性比例与任何长达3个月的等待期无关(所有相关性均p > 0.05)。结论:在这个小型的探索性研究中,手术时间对结果没有明显的影响,这表明在更大的队列中进一步的研究是有必要的。
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Waiting Time following Neoadjuvant Chemoradiotherapy for Rectal Cancer: Does It Really Matter.

Background: Neoadjuvant chemoradiotherapy (CRT) is considered the standard approach before any surgical intervention for locally advanced rectal tumors and has been proven to significantly improve the local recurrence rates of rectal cancer. However, the optimal timing of surgical resection after neoadjuvant CRT remains debatable.

Objective and methods: We conducted a retrospective review of 65 consecutive patients with locally advanced rectal cancer who underwent preoperative CRT followed by surgical resection in order to evaluate the optimal time for surgical treatment. We used two alternative groups for analysis: patients who underwent surgery up to 6 weeks after CRT (n = 28) and those who underwent surgery 6 weeks or more after CRT (n = 27). Also, we compared patients who were operated on within 3 months (n = 39) with those who underwent surgical resection after more than 3 months (n = 16). Nonresponders to CRT were excluded from the analysis.

Results: There was no statistically significant association between waiting period post CRT and radiological downstaging for any group (p > 0.05 for any association). Also, there was no association between recurrence of disease, cancer-related deaths, perineural invasion, or positive lymph node ratio and any waiting period up to 3 months (p > 0.05 for all associations).

Conclusion: In this small exploratory study there was no evident difference in outcome according to timing of surgery, which suggests that further research in larger cohorts is warranted.

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来源期刊
Gastrointestinal Tumors
Gastrointestinal Tumors GASTROENTEROLOGY & HEPATOLOGY-
自引率
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发文量
5
审稿时长
17 weeks
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