在经过全新辅助药治疗后,通过观察和等待策略管理的直肠癌患者的长期阳门功能:一个横截面研究
Lan-Yue Xu1,2,3, Xin Jin1,2,3, Hui Zhang1,2,3
1Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Radiation oncology (London, England)
|October 17, 2025
概括
在全方位的新辅助治疗后,直肠癌患者在观察和等待中通常保持良好的直肠功能,但便急性是常见的. 吸烟史是长期肠道功能障碍的一个关键风险因素.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 临床研究 临床研究
背景情况:
- 在全新辅助治疗 (TNT) 和观察和等待 (W&W) 方法后,对直肠癌患者的长期无直肠功能和直肠毒性进行评估.
- 评估功能性结果,并确定在这个患者队列中治疗后直肠功能障碍的风险因素.
研究的目的:
- 为了评估长期的阳门功能和直肠毒性,直肠癌患者在TNT后用W&W进行管理.
- 为了确定与这些患者直肠功能障碍相关的临床风险因素.
主要方法:
- 单中心,直肠癌患者接受TNT和W&W治疗的横截面研究 (2014年12月 - 2020年11月).
- 没有疾病进展的最低2年的随访,通过半结构面试和验证规模 (RTOG/EORTC,LENT/SOMA,Wexner,LARS,MSKCC BFI) 进行评估.
- 单变和多因素的逻辑回归分析,以确定直肠功能障碍的风险因素.
主要成果:
- 70名患者的中位随访时间为43个月,显示严重直肠毒性的发病率较低 (I级:40.0%,II级:1.4%).
- 便急迫是最常见的症状 (60.0%),其中15.7%的人经历了主要的前底切除综合征 (LARS).
- 吸烟史被确定为长期直肠功能障碍的独立风险因素 (OR 6.562).
结论:
- 在TNT后用W&W管理的直肠癌患者通常可以达到可接受的直肠功能,尽管存在常见的问题,如便紧急性.
- 在这个人群中,吸烟史是长期直肠功能障碍的重要预测因素.
- 建议进一步的前性研究专注于肠道功能结果.
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