局部进展期直肠癌新辅助放化疗后病理完全缓解临床相关因素探究

目的探讨局部进展期直肠癌新辅助放化疗后病理完全缓解（pCR）的临床相关因素。 方法回顾性分析2013年1月至2018年5月期间四川省肿瘤医院肠道外科病区收治的117例局部进展期直肠癌新辅助放化疗及手术的临床资料，采用单因素分析及logistic二分类多因素回归分析法研究pCR的临床相关因素。 结果117例患者全部完成新辅助放化疗及根治手术，其中19例（16.24%）患者达到pCR。单因素分析结果显示，性别为女性（P=0.024），年龄较年轻（P=0.042），放疗前CEA<5 ug/L（P=0.015），无吸烟史（P=0.008），无饮酒史（P=0.037），肿瘤距肛缘距离大于6 cm（P=0.048）和局部进展期直肠癌新辅助放化疗后高pCR率有关。多因素回归分析结果显示，放疗前CEA<5 ug/L（P=0.039）和肿瘤距肛缘距离>6 cm（P=0.043）是影响局部进展期直肠癌新辅助放化疗后pCR率的独立因素。 结论放疗前CEA水平和肿瘤距肛缘距离是影响局部进展期直肠癌新辅助放化疗后pCR率的相关临床因素。

Clinical factors of pathologic complete response after neoadjuvant radiotherapy and chemotherapy for locally advanced rectal cancer

ObjectiveTo investigate the clinical related factors of pathologic complete response (pCR) after neoadjuvant radiotherapy and chemotherapy for locally advanced rectal cancer. MethodsThe clinical data of 117 patients with locally advanced rectal cancer treated in intestinal surgery ward of Sichuan Cancer Hospital from January 2013 to May 2018 were retrospectively analyzed. The clinical related factors of pathologic complete response were studied by univariate analysis and logistic binary classification multivariate regression analysis. ResultsA total of 117 patients were enrolled in the study. All of them completed neoadjuvant radiotherapy, chemotherapy and radical surgery. Nineteen patients (16.24%) achieved pathologic complete response. Univariate analysis showed that the sex was female (P=0.024), the age was younger (P=0.042), the level of CEA before radiotherapy was less than 5 ug/L (P=0.015), no smoking history (P=0.008), no drinking history (P=0.037), the distance between tumor and anal margin was greater than 6 cm (P=0.048) and the high pathologic complete response after neoadjuvant radiotherapy and chemotherapy for locally advanced rectal cancer. The rate is related. Multivariate regression analysis showed that the CEA level before radiotherapy was less than 5 ug/L (P=0.039) and the distance between the tumor and the anal margin was more than 6 cm (P=0.043) were independent factors affecting the pathologic complete response rate of locally advanced rectal cancer after neoadjuvant radiotherapy and chemotherapy. ConclusionThe level of CEA before radiotherapy and the distance between the tumor and the anal margin may be related to the rate of pathologic complete response after neoadjuvant radiotherapy and chemotherapy for locally advanced rectal cancer.