Analysis Of Prognostic Factors Of Different Treatment Modes After Neoadjuvant Radiotherapy And Chemotherapy For Locally Advanced Rectal Cancer

Objective: To investigate the survival and prognostic factors of different treatment modes after neoadjuvant radiotherapy and chemotherapy for locally advanced rectal cancer.Methods:The clinical data of patients with locally advanced rectal cancer who were diagnosed and completed neoadjuvant radiotherapy and chemotherapy in our hospital from January 2010 to June 2018 were analyzed retrospectively.according to the different treatment methods after the completion of neoadjuvant radiotherapy and chemotherapy,they were divided into different subgroups: operation plus chemotherapy group,simple chemotherapy group and waiting observation group.The 5-year overall survival rate,disease-free survival time and adverse events of the subgroup were analyzed.At the same time,Cox multiple regression model was used to analyze the prognostic factors.Results: A total of 147 patients completed neoadjuvant radiotherapy and chemotherapy,including 90 cases of surgery plus chemotherapy,19 cases of consolidation chemotherapy and 38 cases waiting for observation.Kaplan-Meier survival analysis showed that nationality,sex,KPS score,basic disease,family history,distance between focus and anal margin,degree of differentiation and level of swelling resistance had no significant effect on 5-year DFS and 0S.The completion of neoadjuvant radiotherapy and chemotherapy(P ? 0.001,P = 0.002),pathological type(P = 0.038),curative effect(P ? 0.001,P ? 0.001)and metastatic site(P < 0.001)had significant effects on 5-year DFS and 0S,which were the single factors affecting OS.Multivariate COX regression analysis showed that efficacy(P < 0.001)and age(OR = 0.95)were protective factors for 0S,while metastasis was an independent risk factor for OS(P < 0.001,OR=3.02).The incidences of hematology,radiation proctitis and other adverse reactions in the three subgroups were 20.88% and 35.00%,35.71%,respectively.There was no significant difference in adverse reactions among the three groups(Purge 0.401).No grade 3 or moreadverse reactions occurred?Conclusion:The completion of neoadjuvant radiotherapy and chemotherapy,pathological type,curative effect and the site of metastasis are the single factors affecting OS.COX regression analysis showed that the therapeutic effect and age were the protective factors of 0S,and metastasis was the independent risk factor of OS.There was no difference in adverse reactions among the three groups?...