IMMEDIATE RESULTS OF RADICAL SURGERY UNDER CONDITIONS OF COMBINED MODALITY TREATMENT OF RECTAL CANCE
https://doi.org/10.21294/1814-4861-2016-15-1-5-10
Abstract
The purpose of the study was to assess the immediate response to combination therapy including prolonged preoperative concurrent chemoradiotherapy with capecitabine as a radiosensitizer and local hyperthermia for patients with rectal cancer.
Materials and methods. A total of 25 patients received combined modality treatment. The proportions of patients with stages II (T3–4N0 M0 ), III (T1–4N1–2M0 ) and IVa (T1–4N0–2M1 ) were 3 (12 %), 13 (52 %) and 9 (36 %), respectively. The rectal ampulla was diagnosed most frequently (68 %). The patients received preoperative radiation therapy (1.3 Gy twice daily for 5 days per week to a total dose of 54 Gy) concurrently with capecitabine (825 мg/m2 , twice a day for 5 days a week) and local hyperthermia (3 times a week, 3 hours before irradiation session, at temperatures between 42–44°С, for 45–60 minutes, to a maximum of 10 sessions).
Results. Grade 1-2 radiation-induced skin reactions were observed in 3 (12 %) patients. By assessing immediate tumor response 6 months after completing radiotherapy, histologically confirmed complete regression was registered in 2 (8%) patients and partial regression in 23 (92%) patients. Rectal extirpation was performed on 8 (32%) patients and sphincter-preserving surgeries on 15 (68%) patients. Patients with complete regression were followed up. Postoperative complications were observed in 3(12%) patients. None of the patients died. No local recurrence and distant metastases were registered at the 12–18 month follow-up.
Conclusion. Short-and long-term outcomes of combined modality treatment including preoperative concurrent chemoradiotherapy with capecitabine as a radiosensitizer and local hyperthermia indicate that this treatment protocol is effective and safe for patients with stage II–IVа rectal cancer. Concurrent chemoradiotherapy results in a significant tumor regression, thus extending the indications for sphincter-preserving surgery.
About the Authors
S. G. AfanasyevRussian Federation
MD, DSc, Professor, Leading Researcher, Thoracic and Abdominal Department,
5, Kooperativny per., 634009-Tomsk
Zh. A. Startseva
Russian Federation
MD, DSc, Head of the Radiology Department,
5, Kooperativny per., 634009-Tomsk
A. Yu. Dobrodeev
Russian Federation
MD, DSc, Senior Researcher, Thoracic and Abdominal Department,
5, Kooperativny per., 634009-Tomsk
A. S. Tarasova
Russian Federation
MD, PhD, Junior Researcher, Thoracic and Abdominal Department,
5, Kooperativny per., 634009-Tomsk
S. I. Savosina
Russian Federation
post-graduate student, Department of Anesthesiology and Intensive Care, 5, Kooperativny per., 634009-Tomsk;
physician assistant, Department of Anesthesiology and Intensive Care, Kemerovo
A. V. Usova
Russian Federation
MD, PhD, Senior Researcher, Radiology Department,
5, Kooperativny per., 634009-Tomsk
I. S. Polezhaeva
Russian Federation
physician assistant, Department of Radiology,
5, Kooperativny per., 634009-Tomsk
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Review
For citations:
Afanasyev S.G., Startseva Zh.A., Dobrodeev A.Yu., Tarasova A.S., Savosina S.I., Usova A.V., Polezhaeva I.S. IMMEDIATE RESULTS OF RADICAL SURGERY UNDER CONDITIONS OF COMBINED MODALITY TREATMENT OF RECTAL CANCE. Siberian journal of oncology. 2016;15(1):5-10. (In Russ.) https://doi.org/10.21294/1814-4861-2016-15-1-5-10