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在新辅助化学辐射后,直肠癌患者的微观内腔扩散
A E Verrijssen1,2, E J Van Limbergen1, M Bellezzo1
1MAASTRO, GROW School of Oncology and Reproduction, University of Maastricht, Maastricht, the Netherlands.
Clinical and translational radiation oncology
|August 25, 2025
概括
大多数直肠癌患者 (69%) 在新辅助治疗后没有显微内腔扩散 (MIS). 瘤厚度是选择患者进行进一步的辐射增强,如接触式支臂疗法 (CXB) 的关键.
科学领域:
- 大肠直肠手术
- 癌症学
- 辐射瘤学
背景情况:
- 新辅助疗法是直肠癌的标准.
- 在新辅助治疗后评估残留疾病至关重要.
- 微观内壁扩散 (MIS) 影响治疗决策.
研究的目的:
- 在新辅助治疗后对直肠癌患者进行微观内腔扩散 (MIS) 的评估.
- 为了确定辐射增强或局部切除需要额外的治疗边缘.
主要方法:
- 在2016年至2022年期间治疗的54名直肠癌患者的分析.
- 经新辅助成像 (MRI,CT,西格莫视镜) 随后进行全腹腔切除术 (TME).
- 对宏观瘤和MIS (碎片化/连续性) 的TME标本的病理评估.
主要成果:
- 69%的患者 (37/54) 没有可检测的MIS.
- 在22%的ycT1- 2和36%的ycT3- 4瘤中存在MIS.
- 持续的MIS发生在7%的患者中,碎片化的MIS发生在28%的患者中;在ypT1-2瘤中没有MIS.
结论:
- 大多数直肠癌患者在接受新辅助治疗后不会出现MIS.
- 瘤厚度是选择患者接受接触式支臂治疗 (CXB) 的关键因素.
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