TY - JOUR
T1 - SPHINCTER PRESERVATION IN FOUR CONSECUTIVE PHASE II STUDIES OF PREOPERATIVE CHEMORADIATION: ANALYSIS OF 247 T3 RECTAL CANCER PATIENTS.
AU - Gambacorta, Maria Antonietta
AU - Valentini, Vincenzo
AU - Coco, Claudio
AU - Manno, Alberto
AU - Doglietto, Giovanni
AU - Ratto, Carlo
AU - Cosimelli, Maurizio
AU - Micciche', Francesco
AU - Maurizi, Francesca
AU - Tagliaferri, Luca
AU - Mantini, Giovanna
AU - Balducci, Mario
AU - La Torre, Giuseppe
AU - Barbaro, Brunella
AU - Picciocchi, Aurelio
PY - 2007
Y1 - 2007
N2 - 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.
AB - 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.
KW - rectal cancer
KW - rectal cancer
UR - http://hdl.handle.net/10807/114271
U2 - 10.1177/030089160709300209
DO - 10.1177/030089160709300209
M3 - Article
SN - 0300-8916
VL - 93
SP - 160
EP - 169
JO - Tumori
JF - Tumori
ER -