Clinical value of carbon nanoparticles marker for neoadjuvant chemoradiotherapy of rectal cancer / 中华消化内镜杂志

ABSTRACT

Objective To explore the clinical value of carbon nanoparticles marker before neoadjuvant chemoradiotherapy ( NACRT) of locally advanced rectal cancer. Methods Clinical data of 18 patients ( 11 male and 7 female) with locally advanced rectal cancer admitted to Fuzhou General Hospital from July 2015 to December 2015 was analyzed retrospectively. Patients were 45. 8±12. 5 (35-68) years old. Before NACRT, carbon nanoparticles were injected through an endoscope. The multiple-point injection was 1 cm from the lesion ( 4 quadrants of the upper, lower, left and right) to avoid direct injection into the tumor. The injection suspension of carbon nanoparticles was 5 mg per point. After endoscopic marking, the duration of NACRT plus rest was 8 ± 2 ( 5-11 ) weeks, and then the surgery was performed. Effects of endoscopic carbon nanoparticles markers on judgment of the tumor size, the distance from the lower margin of the tumor to the anal border, the intraoperative condition and the rate of anus preservation were observed. Results The operation time was 10. 0±3. 5(5-15)min. No adverse reactions, and bleeding, perforation or other complications occurred. After NACRT, all tumors were reduced, completely disappeared in 7 cases ( 38. 9％) , and pathologically respond in 6 cases ( 33. 3％) . The distance between the lower margin of the tumor and the margin of the anal border was 6. 4 ± 1. 8 ( 4. 5-10. 0) cm. In the operation, 100％ lesions were found to be stained black outside the intestine, with clear location and partial lymph node dysphasia. Eight cases received anus preserving operation, and the rate of anus preservation was 44. 4％. Conclusion The carbon nanoparticles marker can accurately position the tumor and label the lymph node for locally advanced rectal cancer before NACRT. The dyeing effect is lasting, conducive to the surgery or follow-up observation.