新辅助放化疗治疗直肠印戒细胞癌的疗效:一项回顾性倾向评分匹配研究

S. Gordeev, Ya. V. Belenkaya, Z. N. Magarramova, I. Komarov, A. Malikhov, Z. Mamedli, I. Stilidi
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引用次数: 0

摘要

导读:放化疗(CRT)治疗直肠印戒细胞癌(SRCCR)的疗效尚缺乏相关信息。我们的研究目的是探讨术前CRT对SRCCR患者的疗效。患者和方法:我们对来自FSBI“N.N.”研究所档案的医疗记录进行了回顾性分析2000年至2020年,俄罗斯卫生部Blokhin癌症研究中心和俄罗斯结直肠癌专家协会(RSSCC)的多中心注册中心,并将组织学证实的术前接受CRT的原发性SRCCR患者纳入研究组。考虑到性别、年龄、肿瘤大小、cT和cN临床分期,采用机构数据库1:1的倾向评分匹配方法创建了直肠腺癌的对照组。我们估计了Dworak肿瘤消退3-4级率、RECIST、5年总生存率(OS)和无病生存率(DFS)。结果:研究组和对照组各22例。研究组包括11例cT3和cT4临床分期患者(50%)。对照组cT3期10例(45,5%),cT4期12例(54,5%)(p = 0,763)。临床分期为cN1-2的患者,研究组17例(77.3%),对照组16例(72.7%),差异有统计学意义(p = 0.728)。SRCCR组Dworak肿瘤消退3-4级的发生率为40.9%,直肠腺癌组为45.5% (p = 0.761)。通过RECIST量表评估,分别有9例(40.9%)、12例(54.5%)和1例(4.5%)SRCCR患者肿瘤部分缓解、稳定和进展。18例(81.8%)直肠腺癌患者部分缓解,4例(18.2%)患者稳定(p = 0.018)。中位随访时间为558个月。SRCCR组的5年OS为34%,直肠腺癌组为71.3% (p = 0.024), SRCCR组的5年PFS为30.2%,腺癌组为52.2% (p = 0.0115)。结论:CRT治疗SRCCR和直肠腺癌的3-4级肿瘤消退程度相当,但客观缓解率较低。该组织学亚型OS值明显较低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The efficacy of neoadjuvant chemoradiotherapy in signet ring cell carcinoma of the rectum: a retrospective propensity-score matched study
INTRODUCTION: there is a lack of information chemoradiotherapy (CRT) efficacy in signet ring cell carcinoma of the rectum (SRCCR). The aim of our research was to investigate the efficacy of preoperative CRT in patients with SRCCR.PATIENTS AND METHODS: we conducted a retrospective analysis of medical records from the archive of Research Institute FSBI “N.N. Blokhin Cancer Research Center” of the Ministry of Health of Russia and multicenter registry of the Russian Society of Specialists in Colorectal Cancer (RSSCC) from 2000 to 2020 and included in the study group patients with histologically confirmed primary SRCCR who received preoperative CRT. A control group with rectal adenocarcinoma was created using propensity-score matching from the institutional database 1:1 taking into account sex, age, tumor size, the cT and cN clinical stage. We estimated the rate of Dworak tumor regression grade 3-4, RECIST, 5-year overall survival (OS) and disease-free survival (DFS) rates.RESULTS: the study and control group included 22 patients each. The study group included 11 patients (50%) with cT3 and cT4 clinical stage. 10 (45,5%) patients had cT3 clinical stage and 12 (54,5%) patients had cT4 clinical stage in the control group (p = 0,763). The number of patients with cN1-2 clinical stage was 17 (77,3%) and 16 (72,7%) in the study and control group, respectively (p = 0,728). The rate of Dworak tumor regression grade 3–4 was 40,9% in the group of patients with SRCCR and 45,5% in the group of patients with rectal adenocarcinoma (p = 0,761).When assessed by RECIST scale, 9 (40,9%), 12 (54,5%) and 1 (4,5%) patients with SRCCR had partial tumor response, stabilization and progression, respectively. Partial response was observed in 18 (81,8%) patients and stabilization — in 4 (18,2%) patients with rectal adenocarcinoma (p = 0,018). Median followup was 58,8 months. The 5-year OS was 34% in the SRCCR group and 71,3% in the group with rectal adenocarcinoma (p = 0,024), and the 5-year PFS was 30,2% with SRCCR and 52,2% with adenocarcinoma (p = 0,115).CONCLUSIONS: CRT leads to comparable grade 3–4 tumor regression in SRCCR and rectal adenocarcinoma, but the objective response rate is lower. This histological subtype has significantly lower OS values.
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