Fecal incontinence and radiation dose on anal sphincter in patients with locally advanced rectal cancer (LARC) treated with preoperative chemoradiotherapy: a retrospective, single-institutional study
| Autor: | Miguel Ciga, M. Campo, Juan Ignacio Arraras, I. Visus, I. Mora, Fernando Arias, Antonio Viudez, F. Mañeru, C. Eito, S. Flamarique, Gemma Asin, Irene Hernandez, Berta Ibáñez, M. Barrado, M. Errasti, K. Cambra, Leire Arbea |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Colorectal cancer medicine.medical_treatment Locally advanced Urology Anal Canal Adenocarcinoma Radiation Dosage Capecitabine 03 medical and health sciences 0302 clinical medicine Preoperative Care medicine Humans Fecal incontinence In patient Aged Retrospective Studies Aged 80 and over Rectal Neoplasms business.industry Chemoradiotherapy General Medicine Middle Aged Prognosis medicine.disease Surgery Survival Rate Radiation therapy medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Sphincter Female 030211 gastroenterology & hepatology medicine.symptom business Anal sphincter Fecal Incontinence Follow-Up Studies medicine.drug |
| Zdroj: | Clinical and Translational Oncology. 19:969-975 |
| ISSN: | 1699-3055 1699-048X |
| DOI: | 10.1007/s12094-017-1627-0 |
| Popis: | The objective of the study is to determine the correlations among the variables of dose and the sphincter function (SF) in patients with locally advanced rectal cancer treated with preoperative capecitabine/radiotherapy followed by low anterior resection (LAR) + TME. We retrospectively reviewed 92 consecutive patients with LARC treated at our center with LAR from 2006 and more than 2 years free from disease. We re-contoured the anal sphincters (AS) of patients with the help of the radiologist. SF was assessed with the Wexner scale (0–20 points, being punctuation inversely proportional to annal sphincter functionality). All questionnaires were filled out between January 2010 and December 2012. Dosimetric parameters that have been studied include V 20, V 30, V 40, V 50, mean dose (D mean), minimum dose (D min), D 90 (dose received by 90% of the sphincter) and D 98. The correlations among the variables of dose and SF were studied by the Spearman correlation coefficient. Differences in SF relating to maximum doses to the sphincter were assessed by the Mann–Whitney test. Mean Wexner score was 5.5 points higher in those patients with V 20 > 0 compared to those for which V 20 = 0 (p = 0.008). In a multivariate regression model, results suggest that the effect of V 20 on poor anal sphincter control is independent of the effect of distance, with an adjusted OR of 3.42. In order to improve the SF in rectal cancer treated with preoperative radiotherapy/capecitabine followed by conservative surgery, the maximum radiation dose to the AS should be limited, when possible, to |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink