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.
等待和观察策略对于在新辅助化疗或放射治疗后实现完全反应的选择远端直肠癌患者是安全的. 这种方法提供了优秀的器官保存和生存率,避免了许多人的手术.
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:
- 远端直肠癌的治疗通常涉及新辅助化学放射治疗 (NACTRT).
- 一部分患者在NACTRT后获得完全或近乎完全的反应.
- 目前正在为这些患者探索非手术治疗方案.
研究的目的:
- 评估远端直肠癌患者的等待和观察策略 (WWS) 的结果.
- 评估器官保存率 (OPR),局部再生率 (LRR) 和WWS后的存活率.
- 在这个群体中确定与本地再生相关的因素.
主要方法:
- 对61名与NACTRT和WWS (2012-2019) 治疗的远端直肠癌患者的回顾性分析.
- 包括实现完全临床响应 (cCR) 或接近完全响应 (nCR) 的患者.
- 随访包括MRI,西格莫视镜和DRE;使用Kaplan-Meier方法分析生存结果.
主要成果:
- 11%的患者经历了局部再生,大多数通过手术挽救.
- 观察到高器官保存率 (83%),无复发性生存率 (95%) 和整体生存率 (98%).
- 与完全反应 (cCR) 相比,局部再生与近完全反应 (nCR) 有关.
结论:
- 等待和观察策略是安全有效的非手术选择,用于选择的远端直肠癌患者,在NACTRT后出现cCR/nCR.
- 这种方法产生了优秀的器官保存和生存结果.
- 仔细的患者选择和监测对于成功的WWS至关重要.
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