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在局部晚期和局部复发的结肠癌中进行新辅助化疗放射治疗

R A F Agas¹, M Fahey², R R Gosavi³

¹Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.

Clinical oncology (Royal College of Radiologists (Great Britain))

|December 11, 2024

概括

新辅助放射治疗对高风险结肠癌具有前景,在局部发达的初级和复发病例中改善R0切除率. 对化学辐射和全身疗法的进一步研究对于优化局部治疗策略至关重要.

科学领域:

在瘤学瘤学.
手术瘤学手术瘤学
辐射瘤学辐射瘤学

背景情况:

已经建立了对高风险结肠癌的全身治疗方法,但当地管理进展缓慢.
局部控制仍然是一个挑战,特别是在局部先进的初级结肠癌 (LAPC) 和局部复发性结肠癌 (LRC) 中.
识别可能受益于强化局部治疗的患者,如放射治疗,对于最大限度地降低R1切除风险至关重要.

研究的目的:

确定高风险结肠癌患者的一个子集,当地的管理具有挑战性.
评估加强用放射治疗治疗局部治疗的潜在益处,以减少R1切除率.
评估LAPC和LRC患者新辅助放射治疗的结果.

主要方法:

88名患有局部晚期或复发性结肠腺癌,接受新辅助放射治疗 (45-50.4 Gy) 的患者 (40 LAPC, 48 LRC) 的回顾性分析.
随访时间中位数为LAPC的8.1年,为LRC的6.3年.
分析了手术切除和瘤结局.

主要成果:

在LAPC组中,90%的人接受了手术,81%的R0切除和66.7%的病理下降阶段.
在LRC组中,79.2%的人接受了手术,其中65.8%的R0切除.
当地失效率为LAPC的13%,LRC的35% (5年生存率为53%). 在38%的LAPC患者和61%的LRC患者中发生了疾病进展.

结论:

当地的高风险结肠癌管理面临着持续的挑战.
新辅助放射疗法可以改善选择LAPC和LRC患者的切除率和下降阶段.
未来的研究应该专注于新辅助化学辐射,全身疗法和改善分期以确定高风险人群.

关键词:

化学辐射:辐射疗法结肠直肠癌是什么意思这是一种新辅助剂.在手术前进行的术前治疗.

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