직장암의 근치적 수술 후 보조요법으로서의 방사선 치료의 유용성
Is Postoperative Radiotherapy Still Useful for the Rectal Cancer Patients in the Era of Total Mesorectal Excision?
김봉완, 서광욱, 조용관, 임호영, 전미선, 김명욱,
소속 상세정보
김봉완 ( Kim Bong-Wan )
아주대학교 의과대학 외과학교실
서광욱 ( Suh Kwang-Wook )
아주대학교 의과대학 외과학교실
조용관 ( Cho Yong-Kwan )
아주대학교 의과대학 외과학교실
임호영 ( Lim Ho-Yeong )
아주대학교 의과대학 종양혈액내과학교실
전미선 ( Chun Mi-Son )
아주대학교 의과대학 치료방사선과학교실
김명욱 ( Kim Myung-Wook )
아주대학교 의과대학 외과학교실
KMID : 0356719990150050427
Abstract
Purpose: The exact role of postoperative radiotherapy following curative surgery of rectal carcinoma has been debated. In this retrospective study, we examined the effect of radiotherapy on the survival and recurrence rate of rectal cancer patients who underwent total mesorectal excision (TME).
Methods: Since June of 1994, we have recommended postoperative chemoradiation (6 cycles of 5-FU with folinic acid plus 5040 cGy external irradiation) for stage II and III rectal cancer patients. Among 134 stage II and III rectal cancer patients who underwent TME, 100 patients received postoperative chemoradiation (group A) and 34 patients decided not to receive radiation therapy (group B). For these two groups, survival and recurrence rates were compared. Follow-up times were 6 to 60 months (mean 24.7). There was no difference between two groups with regard to sex, stage of the disease, mean tumor location from dentate line, status of lateral margins, type of operation and mean follow-up duration. However, mean age was higher in group B (65.6 vs 53.9, P＜0.05).
Results: The overall recurrence rate showed no difference between two groups (28.0% in group A vs 21.0% in group B, P＞0.05). Local recurrence rate was also similar (11.0% vs 3.0%). There was no significant difference in duration between surgery and initial recurrence (14.0 months vs 11.0 months, P=0.18). The 5-year-disease-free survival rate was 57.0% in group A and 63.0% in group B (P=0.33).
Conclusion: In this study, we found no beneficial effect of postoperative radiation therapy following TME for the rectal cancer.
키워드
Postoperative radiation therapy;Rectal cancer;Total mesorectal excision
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