Long-term quality of life in patients with rectal cancer treated with preoperative (chemo)-radiotherapy within a randomized trial

Tiv, M.; Puyraveau, Marc; Mineur, Laurent; Calais, G.; Maingon, P.; Bardet, É.; Mercier, Mariette; Bosset, J.F.

doi:10.1016/j.canrad.2010.06.017

Cited by 55 publications

(32 citation statements)

References 15 publications

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“…Three randomised trials have been performed. Data from one of the two trials in the intermediate-risk group [ 21 , 22 ] have shown that some dimensions of quality of life are less good in the CRT group [ 95 ]. Late toxicity has also been analysed in the smaller trial in the locally advanced/ugly group.…”

Section: Late Toxicity From Rectal Cancer Radiotherapymentioning

confidence: 98%

Radiotherapy and Chemoradiation for Rectal Cancer: State of the Art in Europe, the USA and Asia

Glimelius

2014

Multidisciplinary Treatment of Colorectal Cancer

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In rectal cancer treatment, not only the local primary but also regional and systemic tumour deposits must be taken care of. The three major treatments, surgery, radiotherapy and drugs, each with their own advantages and limitations, must be combined to result in improved outcomes. Several large randomised trials, reviewed here, have proven that combinations of the three modalities have markedly improved the locoregional problem, but not yet had any major infl uence on the systemic problem, and thus overall survival. The best integration of the so far weakest modality, the drugs, is not known. The results of the trials are interpreted differently in the world. A new generation of trials exploring the best sequence of treatments, together with integration of the novel drugs, is required.

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Section: Late Toxicity From Rectal Cancer Radiotherapymentioning

confidence: 98%

Radiotherapy and Chemoradiation for Rectal Cancer: State of the Art in Europe, the USA and Asia

Glimelius

2014

Multidisciplinary Treatment of Colorectal Cancer

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“…There is a tendency towards more late toxicity in the CRT group, which frequently occurs as fecal and urinary incontinence and erectile dysfunction (Braendengen et al 2011). The addition of chemotherapy to preoperative radiation therapy can impair social functioning (Braendengen et al 2012;Tiv et al 2010). However, Braendengen et al showed there was no statistically significant difference in health-related quality of life between patients who received chemotherapy and those who did not (Braendengen et al 2012).…”

Section: Crt Versus Long-course Radiotherapymentioning

confidence: 99%

Early and Late Toxicity of Radiotherapy for Rectal Cancer

Joye

Haustermans

2014

Recent Results in Cancer Research

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With the implementation of total mesorectal excision surgery and neoadjuvant (chemo) radiotherapy, the outcome of rectal cancer patients has improved and a substantial proportion of them have become long-term survivors. These advances come at the expense of radiation- and chemotherapy-related toxicity which remains an underestimated problem. Radiation-induced early toxicity in rectal cancer treatment mainly includes diarrhea, cystitis, and perineal dermatitis, while bowel dysfunction, fecal incontinence, bleeding, and perforation, genitourinary dysfunction, and pelvic fractures constitute the majority of late toxicity. It is now generally accepted that short-course radiotherapy (SCRT) and immediate surgery is associated with less early toxicity compared to conventionally fractionated chemoradiotherapy with delayed surgery. There are no significant differences in late toxicity between both treatment regimens. While there is hardly an increase in early toxicity after preoperative SCRT with immediate surgery, late toxicity is substantial compared to surgery alone. Early toxicity is more frequent when a longer interval between SCRT and surgery is used and is comparable to the toxicity observed with conventionally fractionated radiotherapy except that it occurs after the end of the radiotherapy. So far, randomized phase III trials failed to demonstrate a substantial gain in tumoural response when oxaliplatin or molecular agents are added to the multimodality treatment. Moreover, the addition of these drugs increases toxicity and remains therefore experimental.

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“…Chemoradiotherapy (CRT) is extensively used prior to rectal cancer surgery for at least the last 10 years when three randomized trials showed that concomitant administration of a fluoropyrimidine improved local control, however, at the expense of increased acute and potentially also late morbidity [1][2][3][4][5]. It was extensively used also prior to that date, extrapolating knowledge from trials using postoperative CRT.…”

Section: Editorialmentioning

confidence: 99%

What is most relevant in preoperative rectal cancer chemoradiotherapy – the chemotherapy, the radiation dose or the timing to surgery?

Glimelius

2016

Acta Oncologica

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Long-term quality of life in patients with rectal cancer treated with preoperative (chemo)-radiotherapy within a randomized trial

Cited by 55 publications

References 15 publications

Radiotherapy and Chemoradiation for Rectal Cancer: State of the Art in Europe, the USA and Asia

Radiotherapy and Chemoradiation for Rectal Cancer: State of the Art in Europe, the USA and Asia

Early and Late Toxicity of Radiotherapy for Rectal Cancer

What is most relevant in preoperative rectal cancer chemoradiotherapy – the chemotherapy, the radiation dose or the timing to surgery?

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