SPHINCTER PRESERVATION IN FOUR CONSECUTIVE PHASE II STUDIES OF PREOPERATIVE CHEMORADIATION: ANALYSIS OF 247 T3 RECTAL CANCER PATIENTS.

Maria Antonietta Gambacorta, Vincenzo Valentini, Claudio Coco, Alberto Manno, Giovanni Doglietto, Carlo Ratto, Maurizio Cosimelli, Francesco Micciche', Francesca Maurizi, Luca Tagliaferri, Giovanna Mantini, Mario Balducci, Giuseppe La Torre, Brunella Barbaro, Aurelio Picciocchi

Risultato della ricerca: Contributo in rivistaArticolo in rivista

13 Citazioni (Scopus)

Abstract

AIMS AND BACKGROUND: To evaluate the impact of preoperative chemoradiation on sphincter preservation in patients with low-medium locally advanced resectable rectal cancer treated by four chemoradiation schedules. MATERIALS AND METHODS: Between 1990 and 2002, 247 patients were treated according to four schedules of chemoradiotherapy: FUMIR (5-fluorouracil, mitomycin, external beam radiotherapy 37.8 Gy), PLAFUR (cisplatinum, 5-fluorouracil, external beam radiotherapy 50.4 Gy),TOMRT (raltitrexed, external beam radiotherapy 50.4 Gy), and TOMOXRT (raltitrexed, oxaliplatin, external beam radiotherapy 50.4 Gy). Four to five weeks after chemoradiation, patients were restaged and surgery was performed 2-3 weeks later. RESULTS: Overall, the sphincter-saving surgery was performed in 82.5% of patients. In patients candidate to an abdominoperineal resection before chemoradiaton (distance tumor-anorectal ring, < 30 mm) a sphincter-saving surgery was possible in 58% of cases: 44% (FUMIR), 52% (PLAFUR), 63% (TOMRT), 76% (TOMOXRT) (P < 0.017). The involved surgeons kept the same surgical criteria in performing sphincter-saving surgery. After chemoradiation, patients with tumor location still between 0 and 30 mm received sphincter-saving surgery according to the protocols: 33% (FUMIR), 42% (PLAFUR), 50% (TOMRT), 64% (TOMOXRT) (P = 0.066). CONCLUSIONS: Even though the surgeons' skill in performing sphincter-saving surgery could be improved with time, the high rate of this procedure in the latest schedules suggests an impact of the new drugs in promoting tumor downsizing and therefore sphincter-saving surgery.
Lingua originaleEnglish
pagine (da-a)160-169
Numero di pagine10
RivistaTumori
Volume93
DOI
Stato di pubblicazionePubblicato - 2007

Keywords

  • rectal cancer

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