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上直肠癌:要照射还是不应该照射?

Basel Darawsha¹, Asaf Harbi¹, Myroslav Lutsky²

¹General Surgery, Rambam Medical Center, Haifa, ISR.

|December 6, 2024

概括

对上直肠癌的新辅助化学放射治疗 (NCRT) 并没有改善局部控制,并增加了低前切除综合征 (LARS). 对上直肠癌患者来说,单独的手术可能是更好的选择,优先考虑生活质量.

科学领域:

在瘤学瘤学.
外科胃肠道外科手术
辐射瘤学辐射瘤学

背景情况:

新辅助化学辐射疗法 (NCRT) 是中低直肠癌的标准.
它在上直肠癌 (11-15厘米从门边缘) 中的作用受到争论.
评估NCRT对上直肠癌结果的影响至关重要.

研究的目的:

为了评估NCRT的安全性和瘤结果,然后进行手术与单独手术治疗上直肠癌.
为了比较术后并发症,死亡率,复发率和功能结果.

主要方法:

对31名局部晚期上直肠癌患者 (2013-2022) 的回顾性队列研究.
患者分为NCRT组 (n=18) 和手术第一组 (n=13).
主要结局:术后并发症;次要:死亡率,复发,低前切除综合征 (LARS).

主要成果:

两组之间死亡率或局部复发没有显著差异.
在NCRT组中,术后并发症的发生率更高 (66.7%vs38.5%).
在NCRT组中,LARS率显著更高 (27.8%与0%相比).

结论:

与单独手术相比,对于上直肠癌的NCRT并没有显著改善局部控制.
NCRT与术后并发症和LARS的增加有关.
需要进一步的研究来优化上直肠癌的治疗,平衡疗效和生活质量.

关键词:

腺癌瘤是一种腺癌.前切除前切除前切除低前切除综合征的前部切除综合征.新辅助剂化学辐射上三分之一的直肠癌.

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