加拿大地区癌症中心联合器官保存治疗肛门癌的经验

R. Koul, S. Mahmood, R. Alvi, M. Salim, H. Chalchal, D. Cross, L. McLean
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引用次数: 0

摘要

背景与目的:肛门癌是一种不同于其他结直肠恶性肿瘤的恶性肿瘤。局部控制和保留括约肌是肛管癌治疗面临的两大挑战。方法和材料:对1970 - 2006年在萨斯喀彻温省癌症登记处登记的经组织学诊断经器官保存方法(如化疗放疗)治疗的肛管或肛缘癌患者进行以人群为基础的历史队列研究。收集了152例患者的数据;只有50名患者符合条件。主要终点为无结肠造口生存期、无疾病生存期和总生存期。评估肿瘤AJCC分期、结期、年龄、放疗剂量对主要终点的影响。毒性按RTOG评分,后期按LENT/SOMA评分。结果:中位年龄58岁(范围31-79岁)。60岁以下30例(60%),60岁以上20例(40%)。平均随访4.2年(8-21年)。总体5年生存率为53%,5年疾病特异性生存率为67%,5年无结肠造口生存率为83%。AJCC分期分组是唯一对无病生存和总生存有统计学显著影响的危险因素。结论:放化疗联合治疗肛门癌是一种有效的治疗方法。出现的晚期对总生存率和无病生存率有不利影响。然而,新的化疗药物和基于IMRT的放疗应该深入研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Regional Canadian Cancer Centre Experience with Combined Modality Organ Preservation Treatment in Anal Cancers
Background and aim: Anal cancer is a malignant phenomenon which is a distinct entity from the other colorectal malignancies. Local control and sphincter preservation are the two challenges of anal canal cancer treatment that physicians face. Methods and Materials: Population based historical cohort with confirmed histological diagnosis of anal canal or anal margin cancer treated with organ preservation approach such as chemo radiation from 19702006 registered with Saskatchewan Cancer Registry was evaluated. Data was collected on 152 patients; only fifty patients were eligible. Primary end points were colostomy free survival, disease free survival and overall survival. The influences of tumor AJCC stage, nodal stage, age, radiation dose on primary end points were also evaluated. Toxicities scored according to RTOG and late by LENT/SOMA scale. Results: Median age was 58 years (range 31-79 years).Thirty patients (60%) were under 60 years of age and 20 (40%) were above the age of 60 years. Mean follow up was 4.2 years (range 8-21 years). Overall 5 year survival was 53%, 5 year disease specific survival was 67% and 5 year colostomy free survival was 83%. AJCC stage grouping was the only risk factor that showed a statistically significant influence on disease free survival and overall survival. Conclusion: Combined radiochemotherapy for anal cancer is a very effective therapy. Advanced stage at presentation has an adverse effect on overall and disease free survival. However new chemotherapeutic drugs and IMRT based radiation should be thoroughly investigated.
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