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Peng Wang¹, Kai Liu¹, Xiaoliang Liu¹

¹Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

Frontiers in oncology

|December 25, 2025

概括

随着剂量升级的新辅助化学辐射疗法在直肠癌患者中显示出高的病理完整反应 (pCR) 率,改善了无病生存率 (DFS). 放射治疗和手术之间的较长间隔进一步增强了pCR.

科学领域:

在瘤学瘤学.
辐射瘤学辐射瘤学
手术瘤学手术瘤学

背景情况:

结直肠癌的治疗通常涉及新辅助疗法,以改善外科手术的结果.
放射治疗中的剂量升级旨在增强瘤反应.
评估新辅助化学放射治疗的疗效和安全性与剂量升级对于优化直肠癌管理至关重要.

研究的目的:

在直肠癌患者中评估新辅助放射治疗的疗效,同时增加剂量,然后进行手术.
为了确定病理完整反应 (pCR) 和关节保存率.
研究放射治疗到手术间隔对pCR和无病生存率 (DFS) 的影响.

主要方法:

在2012年至2019年期间接受治疗的415名直肠癌患者的回顾性审查.
患者接受了新辅助化疗或放射治疗,并增加剂量 (55-56 Gy).
化疗包括capecitabine或capecitabine加上oxaliplatin;手术发生在放射治疗后8-10周.

主要成果:

获得了23.9% (99/415) 的pCR率. 完整瘤反应 (ypT0) 为25.3%,结节反应 (ypN0) 为80.2%.
在86.5%的患者中,关节的保存成功. 3级以上的毒性是低的 (血液学9.7%,GI4.2%,GU1.5%).
放射治疗-手术间隔>10周与较高的pCR相关 (p=0.037). pCR显著改善了DFS (83.33%与62.55%,p=0.0224). 这是一个很好的结果.

结论:

随着剂量升级的新辅助化学辐射疗法为直肠癌中初级瘤和淋巴结提供高PCR率,具有可控的毒性.
实现pCR与改善长期无疾病生存率密切相关.
优化新辅助放射治疗和手术之间的间隔可能会提高治疗疗效.

关键词:

同时进行剂量升级.没有疾病的生存率.新辅助性化疗或放射治疗.病态的完整反应.这是直肠癌.毒性的毒性毒性的毒性

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