Strategies of development of programs of complex treatment of patients with primary unresectable locally advanced rectal cancer
- Authors: Barsukov Y.A1, Gordeev S.S1, Fedyanin M.Y.1
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- Issue: No 18 (2012)
- Pages: 37-42
- Section: Articles
- URL: https://journals.eco-vector.com/2073-4034/article/view/279998
- ID: 279998
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Abstract
The article presents the comparative analysis of the two variants of the complex treatment of patients with inoperable locally advanced primary rectal cancer. From 2002 to 2006, seventeen patients underwent chemoradiotherapy (TBD 36 Gy) with the use of fluorouracil, cisplatin, local hyperthermia and surgery after 4-6 weeks. From 2006 to 2011, sixty-four patients underwent chemoradiation therapy (TBD 40 Gy) with the use of capecitabine, oxaliplatin, local hyperthermia, metronidazole in the polymer composition, and operation after 6-8 weeks. The use of the new scheme of complex treatment has increased the overall 2-year survival rate from 68,4 to 91 % (p = 0,157), and disease-free 2-year survival from 62 to 83 % (p = 0,064) due to significant increase in the number of R0-resection from 64,7 to 92,2 % (p = 0,009). The frequency of III-IV degree toxicity in the treatment groups were not significantly different (11,8 and 20,3 %, respectively, P = 0,726).
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References
- Vestermark L.W., Jacobsen A., Qvortrup C., et al. P long-term results of a phase II trial of high-dose radiotherapy (60 Gy) and UFT/l-leucovorin in patients with non-resectable locally advanced rectal cancer (LARC) Acta Oncol 2008; 47:428-33.
- Braendengen M., Tveit K.M., Berglund A., et al. Randomized phase III study comparing preoperative radiotherapy with chemoradiotherapy in nonresectable rectal cancer, J Clin Oncol 2008;26:3687-94.
- Glynne-Jones R., Dunst J., Sebag-Montefiore D. The integration of oral capecitabine into chemoradiation regimens for locally advanced rectal cancer: How successful have we been? Ann Oncol 2006;17:361-71.
- Hahnloser D., Nelson H., Gunderson L.L., et al. Curative potential of multimodality therapy for locally recurrent rectal cancer. Ann Surg 2003;237(4):502-8.
- Nicholls R.J., Galloway D.J., Mason A.Y., Boyle P. Clinical local staging of rectal cancer. Br J Surg. 1985;72:S51-52.
- Porschen R., Arkenau H.T., Kubicka S., et al. Phase III study of capecitabine plus oxaliplatin compared with fluorouracil and leucovorin plus oxaliplatin in metastatic colorectal cancer: a final report of the AIO Colorectal Study Group. J Clin Oncol 2007;25:4217-23.
- Andre T., Boni C., Mounedji-Boudiaf L., et al. Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 2004 350:2343-51.
- Hochster H.S., Hart L.L., Ramanathan R.K., et al. Safety and efficacy of oxaliplatin and fluoropyrimidine regimens with or without bevacizumab as first-line treatment of metastatic colorectal cancer: results of the TREE Study. J Clin Oncol 2008; 26:3523-29.
- Scheithauer W., Kornek G.V., Raderer M., et al. Randomized multicenter phase II trial of two different schedules of capecitabine plus oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 2003; 21: 1307-12.
- Ярмоненко С.П. Полирадиомодификация как новый подход к повышению эффективности лучевой терапии опухолей / Радиомодификаторы в лучевой терапии опухолей. Обнинск, 1982. С. 126-27.
- Барсуков Ю.А., Олтаржевская Н.Д., Ткачев С.И. и др. Способ лечения рака прямой кишки. Патент на изобретение № 2234318. Зарегистрирован в Государственном реестре изобретений РФ 20.08.2004.
- Bulow S., Jensen L.H., Altaf R., et al. А national cohort study of long-course preoperative radiotherapy in primary fixed rectal cancer in Denmark. Colorectal Dis 2010;12:е18-23.
- Ferrigno R., Novaes P.E., Silva M.L., et al. Neoadjuvant radiochemotherapy in the treatment of fixed and semi-fixed rectal tumors. Analysis of results and prognostic factors. Radiat Oncol 2006; 28(1):5.
- Frykholm G.J., Pahlman L., Glimelius B. Combined chemo and radiotherapy versus radiotherapy alone in the treatment of primary, non-resectable adenocarcinoma of the rectum. Int J Rad Oncol Biol Phys 2001;50:433-40.
- Gollins S.W., Myint S., Susnerwala S., et al. Preoperative downstaging chemoradiation with concurrent irinotecan and capecitabine отдаленные результаты лечения за счет повышения числа R0-резекций. На основании опыта работы нашего отделения эволюционное развитие разработанной ранее схемы лечения позволило увеличить показатели общей и безрецидивной выживаемости, число случаев R0-резекций и лечебного патоморфоза в этой группе пациентов. in MRI-defined locally advanced rectal cancer: a phase I trial (NWCOG-2). Br J Cancer 2009;101(6):924-34.
- Iles S., Gollins S., Susnerwala S. Irinotecan + 5-fluorouracil with concomitant pre-operative radiotherapy in locally advanced non-resectable rectal cancer: a phase I/II study. Br J Cancer 2008;98(7):1210-16.
- Mathis K.L., Nelson H., Pemberton J.H., et al. Unresectable colorectal cancer can be cured with multimodality therapy. Ann Surg 2008;248(4):592-98.
- Rödel C., Grabenbauer G.G., Schick C.H., et al. Preoperative radiation with concurrent 5-fluorouracil for locally advanced T4-primary rectal cancer. Strahlenther Onkol 2000;176(4):161-67.
- Sanfilippo N.J., Crane C.H., Skibber J., et al. T4 rectal cancer treated with preoperative chemoradiation to the posterior pelvis followed by multivisceral resection: patterns of failure and limitations of treatment. Int J Radiat Oncol Biol Phys 2001;51(1):176-83.
- Levine E.L., Gollins S., Susnerwala S., et al. Phase II study of radiotherapy plus concurrent irinotecan (CPT-11) and infusional 5-fluorouracil (5FU) in the treatment of T3-T4 locally advanced inoperable rectalcancer. J Clin Oncol (Meeting Abstracts) 2004;22(14): 3612.
- Vestermark L.W., Jacobsen A., Qvortrup C., et al. Long-term results of a phase II trial of high-dose radiotherapy (60 Gy) and UFT/l-leucovorin in patients with non-resectable locally advanced rectal cancer (LARC). Acta Oncol 2008;47(3):428-33.
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