Distal intramural spread of rectal cancer after preoperative radiotherapy: The results of a multicenter randomized clinical study
| Autor: | Lucyna Kepka, Andrzej Wojnar, Rafał Sopyło, Jacek Sygut, Anna Nasierowska-Guttmejer, Przemysław Majewski, Tomasz Huzarski, Marek P. Nowacki, Andrzej Karmolinski, P. Wandzel, Ewa Chmielik, Krzysztof Bujko |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Antimetabolites Antineoplastic Cancer Research medicine.medical_specialty Neoplasm Residual Preoperative radiotherapy Colorectal cancer medicine.medical_treatment Leucovorin Citrovorum factor Anal Canal Statistics Nonparametric Clinical study Delayed surgery Humans Medicine Radiology Nuclear Medicine and imaging Gy Radiation Aged Neoplasm Staging Chi-Square Distribution Radiation Rectal Neoplasms business.industry Significant difference Radiotherapy Dosage Middle Aged medicine.disease Combined Modality Therapy Surgery Radiation therapy Oncology Female Fluorouracil business Nuclear medicine |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 65:182-188 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2005.11.039 |
| Popis: | Purpose: To evaluate the extent of distal intramural spread (DIS) after preoperative radiotherapy for rectal cancer. Methods and Materials: A total of 316 patients with T{sub 3-4} primary resectable rectal cancer were randomized to receive either preoperative 5x5 Gy radiation with immediate surgery or chemoradiation (50.4 Gy, 1.8 Gy per fraction plus boluses of 5-fluorouracil and leucovorin) with delayed surgery. The slides of the 106 patients who received short-course radiation and of the 86 who received chemoradiation were available for central microscopic evaluation of DIS. Results: The length of DIS did not differ significantly (p = 0.64) between the short-course group and the chemoradiation group and was 0 in 47% vs. 49%; 1 to 5 mm in 41% vs. 42%; 6 to 10 mm in 8% vs. 9%, and greater than 10 mm in 4% vs. 0, respectively. Among the 11 clinically complete responders, DIS was found 1 to 5 mm from the microscopically detected ulceration of the mucosa in 5 patients. The discontinuous DIS was more frequent in the chemoradiation group as compared with the short-course group (i.e., 57% vs. 16% of cases, p < 0.001). Conclusions: Approximately 1 out of 10 advanced rectal cancers after preoperative radiotherapy ormore » radiochemotherapy was characterized by DIS of over 5 mm. No significant difference was seen in the length of DIS between the 2 groups.« less |
| Databáze: | OpenAIRE |
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