Neoadjuvant chemoradiotherapy with capecitabine followed by laparoscopic resection in locally advanced tumors of middle and low rectum – Toxicity and complications of the treatment
| Autor: | R. Kycina, Bartos J, Skrovina M, Soumarová R, Czudek S, J. Gruna, J. Parvez, A. Wendrinski |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Antimetabolites Antineoplastic medicine.medical_specialty Time Factors Colorectal cancer medicine.medical_treatment Rectum Deoxycytidine Capecitabine Postoperative Complications medicine Humans Prodrugs Prospective Studies Laparoscopy Colectomy Aged Neoplasm Staging Aged 80 and over Chemotherapy Dose-Response Relationship Drug medicine.diagnostic_test Rectal Neoplasms business.industry General Medicine Middle Aged medicine.disease Neoadjuvant Therapy Surgery Radiation therapy Regimen Treatment Outcome medicine.anatomical_structure Oncology Concomitant Female Fluorouracil business Follow-Up Studies medicine.drug |
| Zdroj: | European Journal of Surgical Oncology (EJSO). 36:251-256 |
| ISSN: | 0748-7983 |
| DOI: | 10.1016/j.ejso.2009.10.002 |
| Popis: | Aims The aim of this prospective study is to elucidate feasibility of protocol of neoadjuvant concomitant radiochemotherapy with capecitabine and long course radiotherapy with subsequent laparoscopic rectal resection. We assessed treatment toxicity, downstaging rate, pathological response to the neoadjuvant treatment, surgery complications, rate of conversions and sphincter-preserving surgical procedures, and intraoperative and early postoperative complications too. Methods We acquired data of 78 patients from 1 January 2005 to 31 December 2007 with a locally advanced rectal cancer in our study. All patients were indicated for the neoadjuvant concomitant chemoradiotherapy due to locally advanced tumor (T3 or T4) or lymph nodes involvement suspicion (N+). Both radiotherapy (to pelvic region) and chemotherapy (capecitabine) were administered. Rectal tumors were localized within 12cm from the anocutaneous verge. The average follow-up time was 23.9 months. Results All patients completed their treatment according to the planned regimen and dose. The surgery was performed laparoscopicaly within 4–8 weeks following the concomitant chemoradiotherapy – in 17% cases was converted into conventional surgery. Downstaging was achieved in 69% of patients, pathological complete response in 10%, histologically negative lymph nodes were documented in 58% of patients. Grade 3 toxicity of the concomitant chemoradiotherapy was present in 3%; grade 2 in 29% of patients, particularly skin and gastrointestinal form. Intraoperative and early postoperative complications of the surgery were 18%. Re-operation was needed in 5% cases. Conclusions We demonstrated safety and low toxicity of the concomitant chemoradiotherapy with capecitabine. |
| Databáze: | OpenAIRE |
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