在直肠癌中接受新辅助化疗或放射治疗后手术的最佳时间:回顾性分析
Mojtaba Ahmadinejad1, Arash Parvizi2, Saman Sheikhi1
1Department of Surgery, School of Medicine, Alborz University of Medical Science, Karaj, Iran.
概括
新辅助化学放射治疗 (NCRT) 和直肠癌手术之间的最佳间隔是9-11周. 这种时间最大限度地提高了病理完整反应 (pCR),而不会增加术后并发症.
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:
- 优化治疗时间对于局部晚期直肠癌 (LARC) 来说至关重要.
- 术后的新辅助化学放射治疗 (NCRT) 是标准的LARC治疗方法.
- 在NCRT和手术之间的间隔会影响治疗的有效性.
研究的目的:
- 确定NCRT和手术之间的最佳间隔,以最大限度地提高LARC患者的病理完整反应 (pCR).
- 确定PCR的预测因子,并分析手术时间和PCR概率之间的关系.
- 评估手术间隔对术后并发症的影响.
主要方法:
- 对226名LARC患者进行了回顾性队列研究.
- 接收器操作特征 (ROC) 分析,以确定pCR的最佳间隔.
- 多变量逻辑回归和线条回归用于分析预测因素和时间效应.
主要成果:
- 10.5周的间隔被ROC分析确定为最佳时间.
- 手术间隔是pCR的显著预测指标 (OR=2.603,P=0.045).
- 9-11周的间隔最大限度地提高了pCR的概率;超过10周的间隔没有观察到并发症的显著差异.
结论:
- 在NCRT和手术之间的9-11周间隔优化了LARC中的pCR率.
- 这个间隔可以提高治疗结果,而不会增加术后风险.
- 这一时间框架代表了在直肠癌管理中进行手术干预的有利窗口.
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