直肠癌术前放化疗效果与术后降分期对照研究

被引：9

作者：

孙应实 ^{[1
]}

张晓鹏 ^{[1
]}

唐磊 ^{[1
]}

顾晋 ^{[2
]}

季加孚 ^{[2
]}

曹崑 ^{[1
]}

李洁 ^{[1
]}

机构：

[1] 北京大学临床肿瘤学院北京肿瘤医院暨北京市肿瘤防治研究所医学影像科

[2] 北京大学临床肿瘤学院北京肿瘤医院暨北京市肿瘤防治研究所胃肠外科

来源：

中国实用外科杂志 | 2007年 / 11期

基金：

北京市自然科学基金;

关键词：

磁共振成像; 直肠癌; 放化疗;

D O I：

暂无

中图分类号：

R735.37 [];

学科分类号：

100214 ;

摘要：

目的探讨直肠癌术前放化疗的应用价值。方法对北京肿瘤医院2004年12月至2006年10月收治的42例原发性直肠癌病人术前应用1.5T磁共振成像(MRI)测量不同监测时间点的肿瘤体积。比较肿瘤体积变化与T降期、N分期的关系。T降期是将术后病理分期与治疗前磁共振成像临床分期进行对照。结果T降期与T未降期两组肿瘤体积平均缩小率差异无显著性意义(t=1.585,P>0.05);两组放化疗前与手术前肿瘤平均体积差异有显著性意义(t=0.007,P<0.01)。N0与N1、2两组放化疗前肿瘤平均体积差异无显著性意义(P>0.05),手术前肿瘤体积和肿瘤体积缩小率差异有显著性意义(P<0.01)。结论放化疗前肿瘤体积较大者倾向于较差的T分期。放化疗后缩小率高的直肠癌淋巴结转移阴性可能性更大。直肠癌术前放化疗肿瘤缩小率对于肿瘤T分期是否降期的预测和评估准确性较低。直肠癌术前放化疗过程的不同时间点体积变化无法准确提示肿瘤是否降期。

引用

页码：883 / 887

页数：5

共 10 条

[1] 直肠癌扩散加权成像b值选取及其对直肠癌显示能力的评价附视频 [J].

孙应实 ;

张晓鹏 ;

唐磊 .

中国医学影像技术, 2005, (12) :1839-1843

[2]

A comparative study of volumetric analysis, histopathologic downstaging, and tumor regression grade in evaluating tumor response in locally advanced rectal cancer following preoperative chemoradiation[J] . Nam Kyu Kim,Seung Hyuk Baik,Byung Soh Min,Hong Ryull Pyo,Yun Jung Choi,Hogeun Kim,Jinsil Seong,Ki Chang Keum,Sun Young Rha,Hyun Cheol Chung.International Journal of Radiation Oncology, Biology, Physics . 2007 (1)

[3]

Oncologic Outcomes After Neoadjuvant Chemoradiation Followed by Curative Resection With Tumor-Specific Mesorectal Excision for Fixed Locally Advanced Rectal Cancer: Impact of Postirradiated Pathologic Downstaging on Local Recurrence and Survival[J] . Nam Kyu Kim,Seung Hyuk Baik,Jin Sil Seong,Hoguen Kim,Jae Kyung Roh,Kang Young Lee,Seung Kook Sohn,Chang Hwan Cho.Annals of Surgery . 2006 (6)

[4]

Preoperative radiotherapy for rectal adenocarcinoma: Which are strong prognostic factors?[J] . Olivier Chapet,Pascale Romestaing,Francoise Mornex,Jean-Christophe Souquet,Veronique Favrel,Jean-Michel Ardiet,Anne D’Hombres,Jean-Pierre Gerard.International Journal of Radiation Oncology, Biology, Physics . 2005 (5)

[5] Patterns of morphologic alteration in residual rectal carcinoma following preoperative chemoradiation and their association with long-term outcome [J].

Shia, J ;

Guillem, JG ;

Moore, HG ;

Tickoo, SK ;

Qin, J ;

Ruo, L ;

Suriawinata, A ;

Paty, PB ;

Minsky, BD ;

Weiser, MR ;

Temple, LK ;

Wong, WD ;

Klimstra, DS .

AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 2004, 28 (02) :215-223

[6] T-level downstaging and complete pathologic response after preoperative chemoradiation for advanced rectal cancer result in decreased recurrence and improved disease-free survival [J].

Theodoropoulos, G ;

Wise, WE ;

Padmanabhan, A ;

Kerner, BA ;

Taylor, CW ;

Aguilar, PS ;

Khanduja, KS .

DISEASES OF THE COLON & RECTUM, 2002, 45 (07) :895-903

[7]

Rectal tumour staging: MR imaging using pelvic phased-array and endorectal coils vs endoscopic ultrasonography[J] . L. Blomqvist,M. Machado,C. Rubio,N. Gabrielsson,S. Granqvist,S. Goldman,T. Holm.European Radiology . 2000 (4)

[8]

Apoptosis, proliferation, Bax, Bcl-2 and p53 status prior to and after preoperative radiochemotherapy for locally advanced rectal cancer[J] . International Journal of Radiation Oncology, Biology, Physics . 1998 (3)

[9] SPHINCTER PRESERVATION WITH PREOPERATIVE RADIATION-THERAPY AND COLOANAL ANASTOMOSIS [J].

MINSKY, BD ;

COHEN, AM ;

ENKER, WE ;

PATY, P .

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1995, 31 (03) :553-559

[10] CONSERVATIVE SURGERY FOR LOW RECTAL-CARCINOMA AFTER HIGH-DOSE RADIATION - FUNCTIONAL AND ONCOLOGIC RESULTS [J].

ROUANET, P ;

FABRE, JM ;

DUBOIS, JB ;

DRAVET, F ;

SAINTAUBERT, B ;

PRADEL, J ;

YCHOU, M ;

SOLASSOL, C ;

PUJOL, H .

ANNALS OF SURGERY, 1995, 221 (01) :67-73

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