Đánh giá kết quả hóa-xạ trị tiền phẫu và phẫu thuật ung thư trực tràng tiến triển tại chỗ

Abstract

Objective: To evaluate the effectiveness of preoperative chemoradiotherapy regimen and surgical outcomes after chemoradiotherapy in patients with locally advanced rectal cancer. Subject and method: Conducted on 38 patients with locally advanced stage rectal cancer who underwent surgery with preoperative chemoradiation therapy with radiation dose of 45Gy/25 fractions combined with capecitabine 825mg/m² on radiotherapy days at Hue Central Hospital from 02/2020 to 10/2022. Result: The mean age was 56.5 ± 12.5 years old, with a male/female ratio of 2.16/1. The most common clinical symptom was defecation desorders (63.2%). The majority of tumors were in lower and middle rectum 84.2%. Adenocarcinoma was the predominant with 86.8%. Before radiation therapy, tumors were mainly in stage II, III, respectively, 23.7% and 76.3%, after treatment, there was a significant reduction in stage I, II with the rate of 50% and 21.1%, respectively. The rate of T stage lowering was 48.6% and N node stage reduction was 48.6%. The percentage of patients with partial response and complete response on imaging were 50% and 7.9%, respectively. Laparoscopy accounted for the majority with 86.8%, average surgery time 153 ± 15 minutes, average hospital stay was 9.82 ± 3.69 (5-23) days, the average number of lymph nodes removed was 5.86 ± 4 (1-15) lymph nodes. There was 13.1% cases not detect tumor microscopically. Pull-through surgery accounted for the majority and the rate of sphincter preservation in the lower rectal group was at 61.1%. Intraoperative complications were low (2.6%). Conclusion: Preoperative chemoradiotherapy is an effective treatment and safe for surgery with patient suffer locally advanced rectal cancer.