직장암의 수술후 방사선치료성적
The Results of Postoperative Radiation Therapy in the Rectal Cancer
대한암학회지 1997년 29권 1호 p.111 ~ 116
소속 상세정보
유미령/Mi Ryeong Ryu
장홍석/윤세철/정수미/김연실/김세경/김인철/신경섭/Hong Seok Jang/Sei Chul Yoon/Su Mi Chung/Yeon Shil Kim/Se Kyung Kim/In Chul Kim/Kyung Sub Shinn
KMID : 0360319970290010111
Abstract
결론
1984년에서 1993년까지 가톨릭대학교 의과대학 강남성모병원 치료방사선과에서 근치적 수
술 후 방사선치료를 받은 70명의 직장암 환자를 대상으로 추적조사가 가능한 64명에 대한
성적분석 결과 다음과 같은 결론을 얻었다
1) 전체 환자의 2년 및 5년 생존율은 70.3%, 51.4%였고, 병기 B2+3은 90.9%,
90.9%, 병기 C는 68.2%, 53.6%로 병기간의 생존율의 차이가 통계학적으로 유의하였다
(P<0.05).
2) 전체 환자의 2년 및 5년 무병생존율은 63.1%, 48.5%였다.
3) 국소실패율은 전체 환자의 20.3%였으며 전천골강이 가장 많았다
4) 원격전이율은 전체환자의 18.7%였으며 간이 가장 많았다.
5) 합병증은 수술을 요하는 소장폐색증이 3예(5%)에서 나타났으나 치명적인 예는 없었다.
6) 예후인자로는 병기(P=0.0019)와 조직학적 분화정도(P=0.0046)가 통계학적으로 유의하게
나타났다.
#초록#
Purpose : This study was designed to evaluate the prognostic factors, survival rate
and local recurrence rate of the patients with rectal cancer who received postoperative
radia- tion therapy.
Methods & Materials : Seventy patients with rectal cancer received postoperative
radiation therapy after curative surgery at the Department of Therapeutic Radiology,
Kangnam St. Mary's Hospital, Catholic University Medial College between May 1984
and April 1993. Of the seventy patients, sixty-four evaluable patients were analysed
retrospectively. There were 34 men and 28 women. Age at diagnosis ranged from 23 to
74 years. The distribution of stage according to the modified Astler-Coiler(MAC) system
was as follow: 12 in B2+3 in C1, and 50 in C
2+3. Postoperative adjuvant therapy included pelvic radiotherapy in all cases and
chemotherapy in addition in 55 cases.4 total dose of 45 to 60 Gy(median dose: 55.8Gy)
was delivered in a period of 5 to 6 weeks and the follow-up period ranged from 26 to
133 months with a median of 55 months.
Results : Overall two-year and five-year actuarial survival rate were 70.3% and
51.4%, 90.9% and 90.9% in stage B2.3, and 68.2% and 53.6% in stage C. Local failure
occurred in 13(20.3%) of the'64 patients and distant failure rate was 18.8%(12/64).
Severe late complication was small bowel obstruction in 4 patients and surgery was
required in 3 patients(5%). The significant prognostic factors were stage(p=0.0019) and
histologic differentiation (p=0.0046).
Conclusion : This study suggested a potential adjuvant role for radiation. However,
the possible reduction in local failure rates in this study compared with historic control
groups must be verified in randomized trial.
키워드
Rectal cancer; Postoperative radiation therapy;
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