Đánh giá đáp ứng hoá xạ trị trước mổ trong điều trị ung thư trực tràng thấp

Abstract

Low rectal cancer (LRC), a subset of rectal malignancies, is defined as malignant lesions located ≤ 5cm from the anal verge. In this study, 35 patients diagnosed with clinical stage II–III low rectal adenocarcinoma were treated with neoadjuvant chemoradiotherapy (CRT), utilizing a regimen of 50.4 Gy in combination with oral Capecitabine. Post-treatment reassessment showed a reduction in T3–T4 tumors from 88.6% (31 patients) to 22.9% (8 patients). The incidence of regional lymph node metastasis decreased from 54.3% to 8.6%. All patients subsequently underwent curative (R0) resection, with a sphincter-preservation rate of 48.5%. The pathological complete response (pCR) rate was 11.4%. Most adverse events were grade 1–2, predominantly hematologic toxicities and radiation-induced proctitis. Neoadjuvant CRT in stage II–III low rectal cancer achieved a high tumor response rate and significantly improved the rate of curative resections, particularly with respect to sphincter-sparing procedures.