包括术前化疗在内的上部直肠癌多模式治疗效果

A. Dobrodeev, A. Tarasova, S. G. Afanasiev, D. Kostromitsky, A. A. Ponomareva, N. Babyshkina
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引用次数: 0

摘要

目的:分析上段直肠癌患者术前化疗与FOLFOX 4方案等多模式治疗的效果。分别有 2 例(8.3%)和 22 例(91.7%)患者确诊为 II 期和 III 期。所有患者均接受了 3 个周期的 FOLFOX 4 方案化疗,随后进行了手术。术后,T4和N+患者接受了包括术前治疗时间在内的6个月的辅助化疗。化疗毒性为38.9%;不良反应未超过I-II级。18名患者(75.0%)达到了肿瘤部分消退(RECIST 1.1标准)。所有患者均在化疗后 4 周接受了手术。4例(16.7%)患者出现术后并发症,1例(4.2%)出现IIIb级并发症(Clavien-Dindo评分),需要再次手术。1例(4.2%)患者出现病理完全反应(按曼达尔评分法,TRG1)。13名患者(54.2%)接受了辅助化疗。平均随访时间为 38(17-54)个月。3名患者(12.5%)出现局部复发,4名患者(16.7%)出现远处转移。结论:包括 FOLFOX 4 方案术前化疗在内的多模式治疗对上部直肠癌患者的耐受性良好,并能使肿瘤消退,3 年生存率较高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcomes of multimodal treatment including preoperative chemotherapy for upper rectal cancer
Aim: to analyze outcomes of multimodal treatment including preoperative chemotherapy with FOLFOX 4 regimen in patients with upper rectal cancer.Patients and Methods: the pilot study included 24 patients. Stages II and III were confirmed in 2 (8.3%) and 22 (91.7%) patients, respectively. All patients underwent 3 cycles of chemotherapy in FOLFOX 4 regimen followed by surgery. In the postoperative period, patients with T4 and N+ underwent adjuvant chemotherapy administered over 6 months including the time of preoperative treatment.Results: all patients completed preoperative chemotherapy with the FOLFOX 4 regimen. The toxicity of chemotherapy was 38.9%; adverse events did not exceed grades I-II. Partial tumor regression (RECIST 1.1 criteria) was achieved in 18 (75.0%) patients. All patients underwent surgery 4 weeks after chemotherapy. Postoperative complications occurred in 4 (16.7%) patients, 1 (4.2%) had grade IIIb complication (Clavien-Dindo scale), which required re-surgery. Pathological complete response (TRG1 by Mandard scale) was revealed in 1 (4.2%) patient. Thirteen patients (54.2%) received adjuvant chemotherapy. The mean follow-up was 38 (17-54) months. Three patients (12.5%) developed local recurrence and 4 (16.7%) patients — distant metastases. The 3-year overall and diseasefree survival rates were 91.7% и 79.2%, respectively.Conclusion: multimodal treatment including preoperative chemotherapy with the FOLFOX 4 regimen was well tolerated and produced tumor regression with high 3-year survival rates in patients with upper rectal cancer.
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