Kết quả bước đầu điều trị tân bổ trợ toàn diện bệnh nhân ung thư trực tràng xâm lấn tại chỗ tại vùng=Preliminary results of total neoadjuvant therapy in patients with locally advanced rectal cancer

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Tác giả: Thuỳ Linh Dương, Nhật Tân Nguyễn, Văn Hùng Nguyễn, Duy Mạnh Phạm, Thị Hoan Phạm, Ngọc Dũng Trần, Trung Bách Trần, Lê Huy Trịnh

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Nghiên cứu y học (Đại học Y Hà Nội), 2024

Mô tả vật lý: tr.44-51

Bộ sưu tập: Metadata

ID: 244808

Thêm vào giỏ

A prospective study was conducted on 36 patients diagnosed with locally invasive rectal adenocarcinoma, treated with total neoadjuvant therapy (TNT) combined with surgery. The TNT regimen included six cycles of FOLFIRINOX chemotherapy, followed by concurrent chemoradiotherapy, surgery, and adjuvant chemotherapy. Results showed that 19.4% of patients achieved a pathological complete response (pCR), and 8.4% had a near-complete response. The majority of patients (72.2%) showed partial response or stable disease. Hematological toxicities included anemia in 52.7% and thrombocytopenia in 41.6% of patients. Common non-hematological toxicities included mucositis (55.6%) and mild diarrhea (50%). Severe toxicities were rare, with no grade 4 toxicities reported. These preliminary findings suggest that TNT is a feasible and safe treatment option for patients with advanced rectal cancer, offering favorable pathological response rates and well-managed toxicities.Nghiên cứu được thực hiện trên 36 bệnh nhân được chẩn đoán ung thư biểu mô tuyến trực tràng xâm lấn tại chỗ, điều trị bằng hóa xạ trị đồng thời kết hợp với hóa chất bổ trợ trước (tân bổ trợ toàn diện - TNT) kết hợp với phẫu thuật. Phác đồ TNT được sử dụng bao gồm 6 chu kỳ hóa trị FOLFIRINOX, tiếp theo là hóa xạ trị đồng thời, phẫu thuật và hóa trị bổ trợ. Kết quả cho thấy 19,4% bệnh nhân đạt đáp ứng hoàn toàn trên mô bệnh học (pCR) và 8,4% có đáp ứng gần hoàn toàn. Phần lớn bệnh nhân (72,2%) có đáp ứng một phần hoặc bệnh ổn định. Các tác dụng phụ huyết học ghi nhận bao gồm thiếu máu ở 52,7% và giảm tiểu cầu ở 41,6% bệnh nhân. Tác dụng phụ ngoài huyết học phổ biến bao gồm viêm niêm mạc (55,6%) và tiêu chảy nhẹ (50%). Tác dụng phụ nghiêm trọng hiếm gặp và không có trường hợp nào ghi nhận tác dụng phụ mức độ 4. Những kết quả bước đầu này chỉ ra rằng TNT là phương pháp điều trị khả thi và an toàn cho bệnh nhân ung thư trực tràng giai đoạn tiến triển, với tỷ lệ đáp ứng mô bệnh học tích cực và các tác dụng phụ được kiểm soát tốt.

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