An analysis of efficacy of pelvic radiotherapy and prognostic factors for stage IV rectal cancer / 中华放射肿瘤学杂志

ABSTRACT

Objective To retrospectively analyze the efficacy of pelvic radiotherapy and prognostic actors for stage IV rectal cancer. Methods From 2000 to 2010, 61 patients with stage IV rectal cancer who eceived pelvic radiotherapy with or without rectal surgery were enrolled as subjects. In those patients, 19 ad both primary and metastatic tumors resected, 19 had only primary tumor resected, and 23 received elvic radiotherapy with both primary and metastatic tumors intact. The Kaplan?Meier method was used to stimate survival rates, and the log?rank test was used for survival difference analysis and univariate rognostic analysis. Comparison of disaggregated data was made by Fisher′s exact test. Results The 5?year verall survival ( OS ) and progression?free survival ( PFS ) rates in all patients were 26% and 17%, espectively. The prognostic analysis showed that stage T4 , positive node, age greater than 65 years, metastasis outside the liver, and intact primary tumor were prognostic factors for OS, while stage T4 , positive ode, and intact primary tumor were prognostic factors for PFS. In patients with both primary and metastatic umors resected, 5?year OS rates in patients treated with and without pelvic radiotherapy were 67% and 2%, respectively (P=0?119). In patients with intact metastatic tumor, 2?year OS rates in patients with esected and intact primary tumor were 52% and 27%, respectively ( P=0?057 ) . Only 4 patients who eceived pelvic radiotherapy alone for primary rectal tumor needed ostomy. Conclusions The value of ostoperative pelvic radiotherapy still needs further studies in patients with stage IV rectal cancer and esectable metastatic tumor. Pelvic radiotherapy for primary tumor achieves definitive treatment outcomes in atients with stage IV rectal cancer and unresectable primary and metastatic tumors.