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題名 | Postoperative Chemotherapy Might Be Indicated on Patients with Pathological Stage Ⅱ Rectal Cancer after Preoperative Concurrent Chemoradiotherapy=術後化學藥物治療對於接受手術前合併電療及化療的第二期直腸癌病人之影響 |
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作者姓名(中文) | 高彬勝; 楊純豪; 王令瑋; 李潤川; 林資琛; 陳維熊; 姜正愷; 王煥昇; 張世慶; 藍苑慈; 林楨國; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷期 | 21:4 2010.12[民99.12] |
頁次 | 頁169-176 |
分類號 | 416.245 |
關鍵詞 | 合併電療及化療; 術前電療合併化療; 術後化學藥物治療; 直腸癌; 存活率; Concurrent chemoradiotherapy; Neoadjuvant chemoradiotherapy; Postoperative chemotherapy; Rectal cancer; Survival; |
語文 | 英文(English) |
中文摘要 | 目的 對於直腸癌的病人,術前合併電療及化療可以增加腫瘤期數降底及腫瘤細胞完全 消失的機會,這次的研究主要是要驗證這個假說,接受手術前合併電療及化療的第二期 直腸癌病人,對於再接受手術後化學藥物治療是有好處的。 方法 從2000 至2004 年期間,共收集有99 位臨床上為第二期及第三期的直腸癌病人, 接受合併電療、化療及根除性手術。電療及化療包括放射線45 Gray 共分20 次,合併 口服藥物Tegafur-uracil 和leucovorin,術後的輔助性化學藥物治療,包括注射12 次的5-FU 和leucovorin,或是每個月口服化學藥物Tegafur-uracil 和leucovorin 三週,為期共六個 月,術後病理為第三期的直腸癌病人,都會安排輔助性化學藥物,病人的基本特性及存 活率分析是利用chi-square 及log-rank 的分析方法。 結果 病理為第二期的直腸癌病人,五年的總存活率及無疾病復發存活率分別為75% 及 57.1%,而病理為第三期的直腸癌病人,五年的總存活率及無疾病復發存活率分別為 86.4% 及65.7%,病理為第二期的直腸癌病人沒有接受化學藥物治療,比病理為第三期 的直腸癌病人有接受化學藥物治療,五年的總存活率及無疾病復發存活率相對來說還要 差一點 (p = 0.058 and 0.333)。 結論 是否病理為第二期的直腸癌病人需要接受化學藥物治療,還需要進一步大規模且 前瞻性的研究來證實。 |
英文摘要 | Purpose. Preoperative concurrent chemoradiotherapy for rectal cancer increases the incidence of down-staging and pathological complete response. This study examined the hypothesis that patients with pathological stage II rectal cancer would benefit from postoperative adjuvant chemotherapy after preoperative concurrent chemoradiotherapy. Methods. Between July 2000 and December 2004, 99 patients with clinical stage II and III rectal cancer who received preoperative concurrent chemoradiotherapy followed by radical surgery were enrolled. Preoperative concurrent chemoradiotherapy involved a radiation dosage of 45 Gy in 20 fractions and oral tegafur-uracil and leucovorin. Regimens for adjuvant chemotherapy were infusional 5-fluorouracil (3000 mg/m2) and leucovorin (150 mg/m2) biweekly for 12 cycles or oral tegafur-uracil (300 mg/m2/day) and leucovorin (60 mg/day) 3 weeks per month over a 6- month period. Adjuvant chemotherapy was arranged for patients with pathological stage III cancer. Basic characteristics were analyzed using the chi-square test. Survival was examined with Kaplan-Meier curves and comparisons were performed using the log-rank test. Results. Five-year overall survival and disease-free survival percentages were 75.0 and 57.1 for patients with pathological stage II, and 86.4 and 67.5 for patients with pathological stage III, cancers, respectively. Patients with pathological stage II rectal cancer who did not receive adjuvant chemotherapy had relatively poorer overall and disease-free survivals compared to those with pathological stage III cancer who received adjuvant chemotherapy (p = 0.058 and 0.333, respectively). Conclusion. Alarge prospective study is indicated to confirm the value of adjuvant chemotherapy for patients with pathological stage II rectal cancer after concurrent chemoradiotherapy and radical surgery. |
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