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국소 진행된 직장암의 수술 전 화학방사선 요법 치료 후 종양반응 분석: 종양체적 변화와 병리조직학적 병기하강과의 상관관계 분석

Other Titles
 Analysis of Criteria for Tumor Response after Preoperative Chemoradiation Therapy for Locally Advanced Rectal Cancer: Correlation between Tumor Volume Reduction and Histopathologic Downstaging 
 김남규  ;  표홍렬  ;  정현철  ;  라선영  ;  조장환  ;  손승국  ;  이강영  ;  백승혁 
 Journal of the Korean Society of Coloproctology (대한대장항문학회지), Vol.20(5) : 296-302, 2004 
Journal Title
 Journal of the Korean Society of Coloproctology (대한대장항문학회지) 
Issue Date
Preoperative chemoradiation ; Rectal cancer ; Tumor volume reduction ; Pathologic downstaging
Purpose: Preoperative chemoradiation treatment (CCRT) for locally advanced rectal cancer has been known to be safe and effective. The aim of study is to find any correlation between tumor volume reduction and histopathologic downstaging in locally advanced rectal cancer by preoperative CCRT. Methods: A total of 16 patients of rectal cancer were selected. They had been T3,4 N (+) preoperatively staged by using a transrectal ultrasonography and pelvic MRI. Radiation was given, a total of 5,040 cGy over 5 weeks, and systemic chemotherapy was also given 5 FU 450 mg/m2 and leucovorin 20 mg/m2 concurrently intravenously during the first and the fifth week of CCRT. Surgery was done 4∼6 weeks after completion of CCRT. A 3D CT image was obtained with AcQsim PQ 5000 3D (Philips, USA). Tumor volume was measured before and after CCRT. Results: The type of operative procedures were abdominoperineal resection 7, low anterior resection 5, coloanal anastomosis 3 and Hartmann operation 1. Volume reduction was ranged from 14.6% to 84.4%. Over a 50% tumor volume reductions were in 9 patients (56.2%). Pathologic complete remission was observed in 2 patients (12.5%), who showed 72% and 58.5% tumor volume reductions. Patients showing pT and/or pN downstaging patients (N=9) had a 55.9% tumor reductions (14.6∼84.4%), and patients showing no pT and/or pN downstaging (N=7) had 51.8% volume reduction (24.7∼79%). Conclusions: Preoeperative CCRT has been thought to be able to decrease tumor size and volume and to increase respectability. However, among our 9 patients who showed over 50% tumor volume reductions, 3 patients did not show any T and N downstaging, which is really important for long-term oncologic outcomes.
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1. College of Medicine (의과대학) > Research Institute (부설연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Baik, Seung Hyuk(백승혁) ORCID logo https://orcid.org/0000-0003-4183-2332
Sohn, Seung Kook(손승국)
Lee, Kang Young(이강영)
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Cho, Chang Hwan(조장환)
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