Elective postoperative radiotherapy after incomplete resection of colorectal cancer

Ghossein, Nemetallah Ā.; Samala, E.; Alpert, Seymour; Deluca, F; Ragins, Herzl; Turner, Sophie; Stacey, Patricia; Flax, H.

doi:10.1007/bf02641870

Cited by 73 publications

(5 citation statements)

References 10 publications

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“…The long-term pelvic tumor control rate of 88% (Table I) is quite comparable with the results after short-term followup of adjuvant pelvic irradiation in other series [2,7,8,10,11], although the times to recurrence in the patients in the present series (described above) suggest that 3-year recurrence-free survival is a reasonable follow-up time period to judge efficacy of adjuvant irradiation. The overall 80 k 8% 7-year overall survival is quite encouraging.…”

Section: Discussionsupporting

confidence: 87%

Long‐term survivors after adjuvant pelvic irradiation in rectal and sigmoid carcinoma: An assessment of late results

Kopelson

1983

Journal of Surgical Oncology

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Twenty-six patients with adenocarcinomas of the rectum, rectosigmoid, or sigmoid colon given adjuvant pre- or postoperative pelvic radiation therapy followed at least 5 years were retrospectively reviewed to evaluate late tumor control and complication rates. The overall 7-year survival rate was 80 +/- 8% with B2,3 patients faring better than C2,3 (94 +/- 6% versus 43 +/- 19%, p less than 0.005). Local pelvic tumor control was achieved in 23/26 patients (88%); patients with high-stage (C2,3) or poorly-differentiated adenocarcinomas had a higher postirradiation pelvic relapse rate (3/11) versus low stage, well or moderately-well differentiated tumors (0/15). A major complication (none fatal) occurred in 2 of 26 patients (8%) and was not correlated with either irradiation dose nor volume. Long-term follow-up is now available on patients who received adjuvant pelvic irradiation for rectal or sigmoid carcinomas and indicates a high pelvic tumor control rate. The 8% major complication rate may be decreased in the future by more sophisticated irradiation treatment planning.

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Section: Discussionsupporting

confidence: 87%

Long‐term survivors after adjuvant pelvic irradiation in rectal and sigmoid carcinoma: An assessment of late results

Kopelson

1983

Journal of Surgical Oncology

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“…After the incomplete resection of locally advanced rectal cancer, the addition of postoperative (adjuvant) RT improves local control and survival in patients with R1 (microscopic residual disease) but is less effective in those with R2 (macroscopic residual disease)[ 38 - 40 ].…”

Section: Prevention and Treatmentmentioning

confidence: 99%

Review of incomplete macroscopic resections (R2) in rectal cancer: Treatment, prognosis and future perspectives

Lara¹,

Jimenez²,

Donoso³

et al. 2021

WJGO

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Colorectal cancer is one of the most prevalent tumours, but with improved treatment and early detection, its prognosis has greatly improved in recent years. However, when the tumour is locally advanced at diagnosis or if there is local recurrence, it is more difficult to perform a complete tumour resection, and there may be a residual macroscopic tumour. In this paper, we review the literature on residual macroscopic tumour resections, concerning both locally advanced primary tumours and recurrences, evaluating the main problems encountered, the treatments applied, the prognosis and future perspectives in this field.

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“…Few series have analyzed their results with regard to the amount of residual tumor remaining after an attempt at maximal resection. In publications from Massachusetts General Hospital (MGI-1) [12] and Albert Einstein Medical Center (AE) [13], the inci" dence of local failure (LF) after external irradiation varied bY the amount of residual disease being approximately 50% (AE: 9 of 18 patients, MGH: 12 of 23 patients) if there was groSS residual versus 15% to 30% (AE: 2 of 13 patients; MGH: 9 of 30 patients) if there was only microscopic residual. In a separate analysis from Mayo Clinic [14J, the incidence of local recur" Modified with permission [25].…”

Section: External Irradiation With or Without Systemic Therapy Or Res...mentioning

confidence: 99%

The role of intra‐operative irradiation in locally advanced primary and recurrent rectal adenocarcinoma

1992

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Useful palliation can often be achieved when standard treatment approaches of external beam irradiation and chemotherapy with or without resection are used for locally advanced primary rectal malignancies. Local control and long-term survival are achieved in only 10% to 50% of patients, however, due to the limited irradiation tolerance of surrounding organs and tissues. Encouraging trends exist in separate intra-operative irradiation analyses from Massachusetts General Hospital and Mayo Clinic with regard to improvement in local control and possibly survival of locally advanced rectal lesions, warranting continued evaluation of such approaches. Disease control within the intra-operative and external irradiation field is decreased, however, when the surgeon is unable to accomplish gross total resection. Therefore it seems reasonable to consistently add 5-Fluorouracil with or without Leucovorin during external irradiation and to evaluate the use of dose modifiers, such as sensitizers or hyperthermia, in conjunction with intra-operative irradiation. Since high systemic failure rates exist with both locally advanced primary and recurrent lesions, more effective chemotherapy needs to be evaluated during external irradiation as well as after completion of such. In view of survival advantages with 5-Fluorouracil plus Leucovorin versus 5-Fluorouracil alone for metastatic disease, this regimen is currently being employed. Even with locally recurrent lesions, the aggressive multimodality approaches including intra-operative irradiation have resulted in improved local control, and long-term survival rates of 20% to 25% versus an expected 5% with conventional techniques in historical series.

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Elective postoperative radiotherapy after incomplete resection of colorectal cancer

Cited by 73 publications

References 10 publications

Long‐term survivors after adjuvant pelvic irradiation in rectal and sigmoid carcinoma: An assessment of late results

Long‐term survivors after adjuvant pelvic irradiation in rectal and sigmoid carcinoma: An assessment of late results

Review of incomplete macroscopic resections (R2) in rectal cancer: Treatment, prognosis and future perspectives

The role of intra‐operative irradiation in locally advanced primary and recurrent rectal adenocarcinoma

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