چاپ صفحه |  صفحه نخست سامانه |  نویسندگان |  اطلاعات تفضیلی |  دانلود مقاله | دانشگاه علوم پزشکی تبریز |
| نویسنده | نفر چندم مقاله |
|---|---|
| سید کاظم میری نژاد | اول |
| محمد حسین صومی | دوم |
| عنوان | متن |
|---|---|
| خلاصه مقاله | Introduction For patients with locally advanced rectal cancer (LARC), neoadjuvant chemoradiotherapy (NCRT) followed by surgery and adjuvant chemotherapy (ACRT) has long been the standard treatment. Disease-free survival (DFS) is a critical endpoint that captures the time to recurrence, either local or distant, or death from any cause. This study evaluated the impact of different treatment strategies on DFS in patients with LARC. Methods we retrospectively reviewed 590 patients with LARC, aged 18 years or older, treated between 2015 and 2021. Eligible tumors were located within 12 cm of the anal verge. Patients were categorized into two groups: those who received NCRT (n=269) and those who received ACRT (n=321). DFS at 1, 3, and 5 years was analyzed using Kaplan–Meier estimates, with log-rank and Breslow tests applied for comparisons. Results The overall median DFS was 79.2 months. Patients in the NCRT group achieved a longer median DFS (75.4 months) compared with those in the ACRT group (68.2 months). For the entire cohort, 1-, 3-, and 5-year DFS rates were 83%, 65%, and 58%, respectively. When stratified by treatment type, DFS rates were higher in the NCRT group (89%, 72%, and 61%) compared with the ACRT group (76%, 59%, and 54%) (p=0.005, Breslow test) (Figure 1). Discussion Patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy (NCRT) achieved superior disease-free survival compared with those receiving adjuvant chemoradiotherapy (ACRT). This benefit is likely driven by improved tumor downstaging, enhanced local control, and higher rates of R0 resection (1,2). Preoperative treatment also improves compliance and enables earlier eradication of micrometastatic disease (3). In contrast, postoperative chemoradiotherapy is frequently delayed or incomplete due to surgery-related morbidity, potentially reducing its effectiveness (4). Overall, these findings support NCRT as the preferred treatment strategy in locally advanced rectal cancer, consistent with both classical and recent clinical trials (1,5–7). Conclusion our findings suggest that NCRT provides a meaningful survival advantage over ACRT in patients with LARC, highlighting its value as the preferred treatment strategy in this setting. |
| کلمات کلیدی | Keywords: Locally Advanced Rectal Cancer; Neoadjuvant Chemoradiotherapy; Adjuvant Chemoradiotherapy; Disease-Free Survival; Treatment Strategy |
| نام فایل | تاریخ درج فایل | اندازه فایل | دانلود |
|---|---|---|---|
| certificate-RC treatment strategies.pdf | 1404/10/07 | 130346 | دانلود |
| ICGH2025.T.S and DFS in RC.jpg | 1404/10/07 | 1828442 | دانلود |
