Đánh giá kết quả điều trị sớm ung thư trực tràng thấp (T3,4N0-2M0) được hóa xạ trị bổ trợ trước tại bệnh viện Ung Bướu Hà Nội=Clinical response to neoadjuvant chemoradiotherapy in lower locally advanced rectal cancer

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Tác giả: Vinh Quang Bùi, Thị Soan Đỗ, Thị Hải Lệ Nguyễn, Anh Đức Phạm, Quang Kiên Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.152-159

Bộ sưu tập: Metadata

ID: 478134

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Đánh giá kết quả sớm và một số tác dụng phụ của phác đồ điều trị ung thư trực tràng thấp (T3,4N0-2M0) được hóa xạ trị bổ trợ trước tại Bệnh viện Ung Bướu Hà Nội từ 01/2022 đến 8/2023 Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả kết hợp hồi cứu với tiến cứu trên bệnh nhân ung thư trực tràng thấp giai đoạn T3,4N0-2M0 được hóa xạ trị đồng thời. Kết quả điều trị được đánh giá bằng lâm sàng và chẩn đoán hình ảnh sau kết thúc điều trị hóa xạ trị đồng thời 06-08 tuần. Kết quả: 41 bệnh nhân đủ điều kiện tham gia nghiên cứu, tuổi trung bình là 56, tỉ lệ nam/nữ là 4,86/1. Có 39 (95,1%) trường hợp giai đoạn T3, 2 (4,9%) trường hợp giai đoạn T4. Bệnh nhân có hạch chủ yếu N1 với 20 trường hợp (48,7%), N0 với 14 trường hợp (34,1%) và N2 với 7 trường hợp (17%). Đáp ứng sau điều trị ghi nhận trên 25 (60,9%) bệnh nhân, trong đó 4 (9,7%) bệnh nhân đạt đáp ứng hoàn toàn. Tác dụng phụ của xạ trị hay gặp nhất là viêm niêm mạc ống hậu môn, trực tràng, trong đó 36 (87,8%) bệnh nhân viêm độ I, 5 (12,2%) bệnh nhân viêm độ II và 32 (78,0%) đau vùng tầng sinh môn. Các tác dụng phụ của capecitabine chủ yếu là hội chứng bàn tay chân độ I (2 bệnh nhân), tăng men gan độ I, II (3 bệnh nhân), tăng creatinine độ I (3 bệnh nhân). Kết luận: điều trị ung thư trực tràng thấp T3,4N0-2M0 bằng hóa xạ trị bổ trước phẫu thuật là phương pháp hiệu quả, an toàn.To evaluate the clincal response subsequent to neoadjuvant chemoradiotherapy in lower locally advanced rectal cancer and adverse effects of this treatment at the Hanoi Oncology Hospital from January 2022 to August 2023 Subjects and methods: Retrospective descriptive study on patients with histologicallyproven rectal adenocarcinoma, T3,4N0-2M0, were treated with preoperative radiotherapy and concurrent Capecitabine. Treatment response were evaluated by clinical and imaging diagnostics 06-08 weeks after completion of concurrent chemoradiotherapy. Results: Totally 41 eligible patients were enrolled. Their median age was 56, with malefemale ratio of 4.86:1. Majority (39 patients- 95.1%) were at T3 stage, the other 2 patients were at T4 stage. The N1 stage were predominant with 20 patients (48.7%), following by N0 with 14 patients (34.1%), and N2 with 7 patients (17%). The response rate after preoperative treatment was high (60.9% - 25/41 patients), of which 4 patients (9.7%) achieved a complete response. The most common adverse effect of radiation was rectal-anal mucositis including 36 patients (87.8%) at grade I, 12.2% (5 patients) at grade II
32 patients (78%) experienced perineal pain. The adverse effects of Capecitabine were mostly grade-I hand-foot syndrome (2 patients), grade I and II elevated transaminases (3 patients) and grade-I elevated creatinine (3 patients). Conclusion: Neoadjuvant chemoradiotherapy is an effective and safe modality for treating lower locally advanced rectal cancer (T3,4N0-2M0).

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