摘要
Objective:Toassesstheresponserateofpatientswithrectaladenocarcinomatoneoadjuvanttherapyandtoidentifythepredictorsofhistologicalregressionafterneoadjuvantradiotherapy(RT)orconcurrentchemoradiotherapy(CCRT).Methods:Thisstudyrecruited64patients.Thepatientshadresectablecancerofthelowerandthemiddlerectum(T3/T4and/orN+)withoutdistantmetastasisandreceivedneoadjuvantRTorCCRTfollowedbyradicalsurgerywithtotalmesorectalexcision(TME)betweenJanuary2006andDecember2011.Thepatientswereclassifiedintonon-response(NR),partialresponse(PR),andpathologiccompleteresponse(pCR)basedontheDworaktumorregressiongradingsystem.Results:Themedianageofpatientswas57years(rangingfrom22to85).Atotalof24patientsweretreatedwithneoadjuvantCCRT,whereas40patientsweretreatedwithRTalone.Abdominoperinealresection(APR)wasperformedon29patients(45%).AnteriorresectionwithTMEwasperformedon34patients(53%).Onepatienthadlocalresection.Histologically,12(19%),24(73%),and28(44%)patientsexhibitedpCR,PR,andNR,respectively.Univariateanalysisrevealedthatthepredictorsoftumorregressionwereasfollows:theabsenceoflymphnodeinvolvementfrominitialimaging(cN0)(P=0.021);normalinitialcarcinoembryonicantigen(CEA)level(P=0.01);hemoglobinlevel≥12g/dl(P=0.009);CCRT(P=0.021);andtumordownstaginginimaging(P=0.001).MultivariateanalysisshowedthatthemainpredictorsofpCRwereCTcombinedwithneoadjuvantRT,cN0stage,andtumorregressiononimaging.Conclusions:IdentifyingthepredictorsofpCRfollowingneoadjuvanttherapyaidstheselectionofresponsivepatientsfornonaggressivesurgicaltreatmentandpossiblesurveillance.
出版日期
2017年03月13日（中国期刊网平台首次上网日期，不代表论文的发表时间）
