Clinicopathological outcomes of preoperative chemoradiotherapy using S-1 plus Irinotecan for T4 lower rectal cancer
| Autor: | Fumihiko Kimura, Hiroshi Doi, Hidenori Yoshie, Norihiko Kamikonya, Naohiro Tomita, Naohito Beppu, Tsukasa Aihara, Nagahide Matsubara, Naoki Yamanaka, Hidenori Yanagi |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Oncology medicine.medical_specialty Time Factors medicine.medical_treatment 030230 surgery Irinotecan Gastroenterology Tegafur 03 medical and health sciences 0302 clinical medicine Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Radical surgery Survival rate Digestive System Surgical Procedures Aged Neoplasm Staging Aged 80 and over Tumor Regression Grade Rectal Neoplasms business.industry Chemoradiotherapy Adjuvant General Medicine Middle Aged Chemotherapy regimen Survival Rate Radiation therapy Drug Combinations Oxonic Acid Regimen Treatment Outcome 030220 oncology & carcinogenesis Preoperative Period Camptothecin Female Surgery business Follow-Up Studies medicine.drug |
| Zdroj: | Surgery Today. 46:852-859 |
| ISSN: | 1436-2813 0941-1291 |
| Popis: | To investigate the clinicopathological outcomes of patients with T4 lower rectal cancer treated using preoperative chemoradiotherapy with S-1 plus Irinotecan. Between 2005 and 2011, 35 patients with T4M0 lower rectal cancer, diagnosed initially as T4a in 12 and as T4b in 23, were treated with 45 Gy of radiotherapy concomitantly with S-1 plus Irinotecan. The median follow-up period was 50.6 months (range 2–123 months). A total of 32 patients (91.4 %) completed the radiotherapy and 26 (74.3 %) completed the full chemotherapy regimen. Radical surgery was then performed in 33 (94.3 %) of the 35 patients after the exclusion of two patients, who had macroscopic residual disease. The pathological diagnosis was downstaged from T4a to ypT0-3 in all 12 of those patients (100 %) and from T4b to ypT0-4a in 20 of those 23 patients (87.0 %). The tumor regression grade of 1a/1b/2/3 (complete response) was 10/8/15/2, respectively. In terms of long-term survival, the 5-year local relapse-free survival rate was 74.8 % and the recurrence-free survival rate was 52.0 %. This regimen may result in favorable downstaging. Moreover, in this series, pathological evidence of involvement of adjacent organs was rare following preoperative chemoradiotherapy, in the patients with disease diagnosed as T4b at the initial staging. |
| Databáze: | OpenAIRE |
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