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中国临床药理学与治疗学 ›› 2005, Vol. 10 ›› Issue (7): 819-823.

• 研究原著 • 上一篇    下一篇

手术为主的综合治疗直肠癌的预后因素分析

邓翀, 陆雪官, 田野   

  1. 苏州大学附二医院放疗科, 苏州215004, 江苏
  • 收稿日期:2005-03-15 修回日期:2005-05-30 出版日期:2005-07-26 发布日期:2020-11-10
  • 通讯作者: 邓翀, 男, 硕士研究生。Tel:(0) 13913516685 E-mail: bachong@eyou.com

Prognostic factors of rectal cancer treated with multimodality therapy based on surgery

DENG Chong, LU Xue-guan, TIAN Ye   

  1. Department of Radiotherapy and Oncology, Second Affiliate Hospital, Suzhou University, Suzhou 215004, Jiangsu, China
  • Received:2005-03-15 Revised:2005-05-30 Online:2005-07-26 Published:2020-11-10

摘要: 目的: 初步探讨影响以手术为主的综合治疗直肠癌的预后因素。方法: 回顾性分析124 例以手术为主的综合治疗直肠癌患者的临床资料。用Kaplan-Meier 法计算生存率和局部控制率, Log-rank 法作差异检验, 多因素分析采用Cox 比例风险模型。结果: 所有患者的随访时间为7 ~ 81 个月。本组病例的5 年总生存率和局部控制率分别为30.6 %和49.1 %。单因素分析结果显示术后病理类型为腺癌、粘液腺癌和印戒细胞癌的患者5 年生存率分别为44.9 %, 0 %和0 %(χ2 =8.67, P =0.0129), 5 年局控率分别为55.2 %, 34.6 %和33.3 %(χ2 =4.86,P =0.0334) 。行辅助放疗与未行辅助放疗者5 年生存率分别为40.4 %和13.3 %(χ2 =7.48, P =0.0062), 5 年局控率分别为73.5 %和37.5 %(χ2 =29.68, P =0.0000) 。而Dukes 分期, 淋巴转移情况, 肿瘤浸润肠壁深度, 直肠系膜全切除(TME) 以及术后辅助化疗等因素与预后无关(P >0.05) 。多因素分析显示辅助放疗与病理类型是影响直肠癌患者生存率的独立预后因素(P =0.009 和0.045), 而对局部复发率进行多因素分析发现仅辅助放疗有统计学意义(P =0.0000) 。结论: 对以手术为主的综合治疗直肠癌病例, 肿瘤病理类型和是否辅以放射治疗是影响其预后的重要因素, 其它因素尚不能肯定。

关键词: 直肠肿瘤, 手术治疗, 放射疗法, 药物治疗, 预后因素

Abstract: AIM: To evaluate the prognosis of rectal cancer treated with multimodality therapy based on surgery. METHODS: The clinical data of 124 rectal cancer patients treated with multimodality therapy based on surgery were investigated and analyzed. Overall survival (OS) and loco-regional control (LC) rates were estimated by Kaplan-Meier method. Log-rankmethod and Cox proportional hazard model were used for identify the prognostic factors, respectively. RESULTS: The follow-up time ranged from 7 to 81 months. The 5-year OS and LC rates were 51.6 % and 49.5 %, respectively. Univariate analysis revealed that the 5-year OS of adencarcinoma, mucinous adenocarcinoma and signet-ring cell carcinoma were 44.9 %, 0 % and 0 %, respectively (χ2 =8.67, P = 0.0129), the 5-year LC were 55.2 %, 34.6 % and 33.3 %, respectively(χ2 =4.86, P =0.0334). The 5- year OS of patients who accepted or not accepted adjuvant radiotherapy were 40.4 % and 13.3 %, respectively (χ2 =7.48, P =0.0062), and the 5-year LC were 73.5 % and 0 %, respectively (χ2 =29.68, P =0.0000). Dukes stage, depth of infiltration, nodal, total mesorectal excision (TME), and adjuvant chemotherapy were not correlated with the prognosis (P >0.05). Multivariate analysis revealed that adjuvant radiotherapy and histology of tumor significantly affected the prognosis(P =0.045 and P =0.009, respectively). Whereas loco-regional control was only significantly affected by adjuvant radiotherapy (P =0.000). CONCLUSION: Adjuvant radiotherapy and histology of tumor are the important prognostic factors in the rectal cancer patients after treatment with multimodality therapy based on surgery.

Key words: colorectal neoplasms /pathology, colorectal neoplasms /surgery, colorectal neoplasms /radiotherapy, colorectal neoplasms drug therapy, prognostic factors

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