Abstract
Objective: to assess the effect of preoperative treatment option on the number of sphincter-preserving operations (SPO) in patients with low rectal cancer. Materials and methods . The patients with low rectal cancer (0—6 cm from anocutaneous line) were randomized into 3 groups: in the 1st control group surgery was performed in 0—3 days after completion of short-course radiotherapy (5 х 5 Gy). Patients in the 2nd control group received identical radiotherapy but the interval before surgery was extended to 42 ± 3 days. Patients in the study group received treatment identical to 2nd control group with 2 additional courses of monochemotherapy with capecitabine, starting on the first day of radiotherapy. The primary endpoint was the number of SPO. Complete pathomorphologic response rate, overall survival, tumor-specific survival and event-free 5-year survival were also assessed as secondary endpoints. Results. Data on 129 patients was analyzed: 46 in the 1st control group, 43 in the 2nd control group, 40 in the study group. The proportion of SPO was 41,3 ± 7,3 % in the 1st group, 69,7 ± 7,0 % and 77,5 ± 6,6 % in the 2nd group and study group, respectively. Complete histological response was achieved in 15 % of patients in study group, comparing to 14,3 % of patients in the 2nd group. Overall 5-year survival in this study was estimated to be 77,8 ± 4,5%, tumor-specific survival — 89,7 ± 3,7 %, event-free survival — 90,1 ± 2,9 %, with no significant differences between groups. Conclusion. Short-course radiotherapy (5 х 5 Gy) with 6-week interval before surgery resulted in increase of SPO rate with no affect on oncologic outcome.
Highlights
The patients with low rectal cancer (0–6 cm from anocutaneous line) were randomized into 3 groups: in the 1st control group surgery was performed in 0–3 days after completion of short-course radiotherapy (5 × 5 Gy)
Patients in the 2nd control group received identical radiotherapy but the interval before surgery was extended to 42 ± 3 days
Overall survival, tumor-specific survival and event-free 5-year survival were assessed as secondary endpoints
Summary
Пациенты с низколокализованным (0–6 см от анокутанной линии) раком прямой кишки были рандомизированы в 3 группы: в 1‐й контрольной операция выполнялась через 0–3 сут после окончания «короткой» лучевой терапии 5 × 5 Гр. Во 2‐й контрольной группе после идентичной лучевой терапии интервал до операции составил 42 ± 3 дня. В основной группе в дополнение к схеме 2‐й группы с 1‐го дня лучевой терапии проводилось 2 курса монохимиотерапии капецитабином. Отдаленные результаты лечения пациентов с низколокализованнным раком прямой кишки. При возможности сопри распространенности рака cТ3–4NxM0 предусма- блюдения дистального клиренса >1 см, отсутствии тривало проведение предоперационной лучевой тера- врастания опухоли в наружный сфинктер или леватопии (ЛТ) крупными фракциями 5 × 5 Гр с интервалом ры заднего прохода по данным трансректального перед хирургическим лечением ≤72 ч [2]; при этом ультразвукового исследования (при предполагаемой 5‐летняя скорректированная выживаемость для I–II глубине инвазии Т2) или магнитно-резонансной тостадий в 2016 г.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.