절제 불가능 직장암에서 방사선 치료의 역할

• 영문명: The Role Radiation Therapy in the Unresectable Rectal Cancers
• 발행기관: 대한방사선종양학회
• 저자명: 김우철(Woo Cheol Kim) 성진실(Jinsil Seong) 김귀언(Gwi Eon Kim)
• 간행물 정보: 『대한방사선종양학회지』제13권 제2호, 173~180쪽, 전체 8쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 1995.06.30

영문 초록

Purpose : Unresectable rectal cancer has a grave prognosis, regardless of the therapy used and median survival is less than 1 year. Also, it is reported by many authors that 50-80% of unresectable lesions were rendered resectable by radiation therapy and the median survival time for the completely resected patients were better than that of the unresected patients. So we analyzed retrospectively our data for the better treatment outcome in these patients. Materials and Methods : From 1980 to 1992. 45 patients with initially unresectable tumors in the rectum were treated with radiation therapy with/without surgery in Department of Radiation Oncology. Yousei Cancer Center. 10 MV radiation and multiple field technique (box or AP/PA) were used. The total dose was 28-70 Gy and median dose was 48 Gy. We evaluated the lesion status at 45-50 Gy for operability. If the lesions appeared to be resectable, the patients were operated on 4-6weeks after radiation therapy. But if the lesions were still fixed, the radiation dose was increased to 60-65 Gy. Results : For all patients, the 2-year actuarial survival was 13.3% and median survival was 9.5 months. Of 6 patients who had received less than 45 Gy, only 17% of patients responded, but in the patients who had received more than 45 Gy, 60% of response rate was achieved. Six of the 24 patients(25%) underwent surgical resections following RT. For patients undergoing curative resection, the two-year survival was 50%, but that of the patients without resection was 9.5%(p<0.01). Survival of patients with complete response following RT was 50% at 2 years. Survival of patients with partial response. stable disease and progressive disease after RT was 13.4%, 15.4%, 0% respectively(p<0.05). Conclusion : Our data suggests that the efforts which can increase the response rate and aggressive surgical approach are needed to achieve the better local control and survival in unresectable rectal cancers.

키워드

Unresectable rectal cancer Radiation theray