Outcomes following a limited approach to radiotherapy in rectal cancer
Autor: | K Vogt, Marko Simunovic, R J Heald, Susannah Jacob, Angela Coates, B J Moran |
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Rok vydání: | 2011 |
Předmět: |
Male
medicine.medical_specialty Preoperative radiotherapy Colorectal cancer medicine.medical_treatment Adenocarcinoma Preoperative care medicine Humans Pelvis Neoadjuvant therapy Mesorectal Aged Digital Rectal Examination Pelvic Neoplasms medicine.diagnostic_test business.industry Rectal Neoplasms Rectal examination Middle Aged medicine.disease Surgery Radiation therapy medicine.anatomical_structure Treatment Outcome Female Radiotherapy Adjuvant Neoplasm Recurrence Local business Tomography X-Ray Computed |
Zdroj: | The British journal of surgery. 98(10) |
ISSN: | 1365-2168 |
Popis: | Background Variation in the use of neoadjuvant and adjuvant radiotherapy for rectal cancer suggests an opportunity to avoid it in all but patients at highest risk of local recurrence. Methods Between 1 July 1999 and 1 February 2006, patients with primary rectal cancer were treated by a single surgeon operating at McMaster University, Hamilton, Ontario, Canada. Digital rectal examination and pelvic computed tomography were used to determine whether the mesorectal margin was threatened by tumour and thus whether preoperative radiotherapy would be needed. The study outcome was local tumour recurrence. Results Forty-six (48 per cent) of 96 patients received preoperative radiation therapy. The median follow-up was 4·2 years. Tumours were fixed or tethered in 31 (67 per cent) of the 46 irradiated patients. In contrast, no tumour was fixed in unirradiated patients and only ten (20 per cent) of the 50 tumours were tethered. The proportion of patients with stage I or II tumours based on final pathology was similar: 61 per cent (28 of 46) and 56 per cent (28 of 50) in irradiated and unirradiated groups respectively (P = 0·287). There were four (9 per cent) and two (4 per cent) local recurrences among irradiated and unirradiated patients respectively (P = 0·422). Conclusion Limiting preoperative radiotherapy in rectal cancer to patients with a threatened circumferential margin does not compromise patient outcome. |
Databáze: | OpenAIRE |
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