An experimental evaluation of three preoperative radiation regimens for resectable rectal cancer (original) (raw)
2002, Annals of Surgical Oncology
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Evaluation of Tumor Response after Short-Course Radiotherapy and Delayed Surgery for Rectal Cancer
PloS one, 2016
Neoadjuvant therapy is able to reduce local recurrence in rectal cancer. Immediate surgery after short course radiotherapy allows only for minimal downstaging. We investigated the effect of delayed surgery after short-course radiotherapy at different time intervals before surgery, in patients affected by rectal cancer. From January 2003 to December 2013 sixty-seven patients with the following characteristics have been selected: clinical (c) stage T3N0 ≤ 12 cm from the anal verge and with circumferential resection margin > 5 mm (by magnetic resonance imaging); cT2, any N, < 5 cm from anal verge; and patients facing tumors with enlarged nodes and/or CRM+ve who resulted unfit for chemo-radiation, were also included. Patients underwent preoperative short-course radiotherapy with different interval to surgery were divided in three groups: A (within 6 weeks), B (between 6 and 8 weeks) and C (after more than 8 weeks). Hystopatolgical response to radiotherapy was measured by Mandard&#...
Asian Journal of Pharmaceutical and Clinical Research Journal, 2022
In locally advanced non-metastatic rectal carcinoma, pre-operative radiotherapy is an acceptable alternative over post-operative radiation to improve locoregional control after radical surgery. There are two regimens of pre-operative radiotherapy-short-course radiotherapy (25 Gy/5 fractions/1 week) and long-course chemoradiotherapy (CRT) (50.4 Gy/28 fractions/5.5 weeks). Our study aimed to compare the pathological response, margin negative surgery rates, and treatment-related acute toxicities between these two approaches. Methods: Patients with histologically proven locally advanced, non-metastatic rectal adenocarcinoma were randomized into study group and control group-the study group received short-course radiotherapy (25 Gy/5 fractions/1 week) followed by surgery after 7-10 days of completion of radiotherapy and the control group received long-course radiotherapy (50.4 Gy/28 fractions/5.5 weeks) with concurrent capecitabine followed by surgery after 4-6 weeks of completion of radiotherapy. Histopathology reports were studied in both groups for the determination of pathological response of tumor and surgical margin status. All patients received adjuvant chemotherapy for 6 months with oxaliplatin and capecitabine. For the assessment of treatment-related acute toxicities, patients were examined during the entire course of treatment. Results: Overall pathological response (complete response+partial response) was 81.25% in the study arm and 86.66% in the control arm. Complete response rate was 15% in the study arm and 25% in the control arm. Margin negative surgery rates were higher in long-course CRT than short-course radiotherapy (90% vs. 82%), but it was statistically insignificant. Radiation-induced acute skin reactions (less than Grade 2) were significantly higher in long-course CRT arm (p=0.003). Conclusion: There is no significant difference between pre-operative short-course radiotherapy and long-course concomitant CRT in terms of efficacy and acute toxicity profile. Thus, with our limited resources and huge patient load, short-course radiotherapy can be used as an acceptable alternative to long-course CRT.
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