在接受化疗辐射的低直肠癌中进行非手术治疗
Debanjali Datta1, Reena Engineer1, Avanish Saklani2
1Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
等待和观察策略 (WWS) 为直肠癌患者提供了一种安全的非手术选择,在新辅助化学辐射后实现完全反应. 这种方法显示出优异的器官保存和生存率,使其成为手术的可行替代方案.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 新辅助化学辐射 (NACTRT) 是远端直肠癌的标准.
- 完全或几乎完全的响应 (cCR/nCR) 允许考虑非操作性管理.
- 等待和观察策略 (WWS) 旨在通过避免立即手术来保护器官.
研究的目的:
- 评估等待和观察策略 (WWS) 在远端直肠癌患者的后新辅助化学辐射治疗 (NACTRT) 后的结果.
- 评估器官保存率 (OPR),局部再生率 (LRR),无复发生存率 (NR-RFS) 和整体生存率 (OS).
主要方法:
- 在NACTRT后实现cCR或nCR的61名远端直肠癌患者的回顾性分析.
- 患者选择了WWS,并通过MRI,西格莫视镜和DRE进行监测.
- 用于生存分析的Kaplan-Meier方法;对于与LRR相关的因子关联的日志等级测试.
主要成果:
- 在平均39个月的随访期间,11%的患者经历了局部再生,大多数人通过手术挽救.
- 整体器官保存率 (OPR) 为83%,非复发复发的无复发存活率 (NR-RFS) 为95%,整体存活率 (OS) 为98%.
- 在接近完全响应 (nCR) 与完全响应 (cCR) (P=0.05) 的患者中,局部再生率 (LRR) 较高.
结论:
- 等待和观察策略 (WWS) 是对精选的远端直肠癌患者的一种安全的非手术治疗选择.
- 在NACTRT后,WWS可以获得优异的器官保存和生存结果.
- 对于那些希望避免手术的cCR/nCR患者来说,WWS提供了一个可行的替代方案.
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