Long-term results of a randomised trial of short-course low-dose adjuvant pre-operative radiotherapy for rectal cancer: Reduction in local treatment failure

Goldberg, P. A.; Nicholls, R. J.; Porter, N. H.; Love, Sharon; Grimsey, J.E.

doi:10.1016/0959-8049(94)00312-s

Cited by 256 publications

(121 citation statements)

References 23 publications

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“…30 To our knowledge, there have been no reports to date of complete tumor regression occurring when surgery is performed within 1 week after the end of radiotherapy, a finding that is consistent with our own data. 10,12,14,16,17,19 In contrast, in studies with a longer interval between the end of radiotherapy and surgery (Ͼ 10 days), complete histologic regression was reported in 2-11% of the patients. 7,30,38 -41 However, to diagnose complete tumor regression, the entire tumor region must be sampled and carefully screened for any small surviving foci of carcinoma by thorough histologic workup.…”

Section: Discussionmentioning

confidence: 97%

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Importance of tumor regression assessment in predicting the outcome in patients with locally advanced rectal carcinoma who are treated with preoperative radiotherapy

Bouzourène

Bosman

Seelentag

et al. 2002

Cancer

253

113

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Section: Discussionmentioning

confidence: 97%

“…In the literature data, a reduced number of lymph node metastases after preoperative radiotherapy was reported in some studies 8,16,18,38,42,44 whereas in other studies no significant difference was found. 12,17,32 …”

Section: Discussionmentioning

confidence: 99%

Importance of tumor regression assessment in predicting the outcome in patients with locally advanced rectal carcinoma who are treated with preoperative radiotherapy

Bouzourène

Bosman

Seelentag

et al. 2002

Cancer

253

113

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“…The use of only anterior and posterior fields for pelvic radiation should be avoided, if possible, because of the high dose and large volume of intestine irradiated. A higher operative mortality was reported in trials using this technique preoperatively for rectal cancers [91,92] . The toxicity of radiation is directly related to the volume of small bowel being irradiated [93] .…”

Section: Prevention Of Radiation Colitismentioning

confidence: 99%

Recent advances in the management of radiation colitis

Kountouras¹,

Zavos²

2008

WJG

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“…However, the existing range of methodologies, inclusion criteria, and therapeutic modalities makes it difficult to analyze such an influence. [14][15][16][17][18] Some studies also show mortality associated with adjuvant combined therapy, 19,20 as well as toxicity and surgical reintervention because of intestinal obstruction 19 and disturbances in bowel habit and incontinence,21,22 associated with radiation.…”

mentioning

confidence: 99%

Analysis of Early Postoperative Morbidity Among Patients with Rectal Cancer Treated with and without Neoadjuvant Chemoradiotherapy

et al. 2007

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Background: The impact of neoadjuvant treatment and their subsequent early complications in the treatment of rectal cancer has not been adequately assessed. The aim of this prospective study was to evaluate early postoperative morbidity and mortality among patients with rectal cancer treated with adjuvant radiotherapy and chemotherapy followed by surgery, compared with patients treated with surgery alone. We also identified independent risk factors associated with early major complications. Methods: Between 1995 and 2004, 273 consecutive patients underwent treatment for rectal cancer. A total of 170 patients (group A) received preoperative radiotherapy with a total of 45-50.4 Gy (180 cGy per day) and 5-fluorouracil-based chemotherapy, followed by surgery; 103 patients (group B) were treated with surgery alone. Dependent variables related to patients, treatment, radiotherapy, and tumor were analyzed. Results: Both groups were similar with regard to age, sex, body mass index, American Society of Anesthesiologists (ASA) score, and tumor location but not for ileostomy (27% in group A vs. 6.8% in group B). The number of complications was similar in both groups (43.1% in group A vs. 44.6% in group B). No differences in wound infection (8.2% vs. 7.8%), intraabdominal abscess (4.7% vs. 4.9%), anastomotic dehiscence (4.2% vs. 3.8%), postoperative hemorrhage (3.5% vs. 3.9%), urinary complications (6.5% vs. 4.9%), paralytic ileus (8.9% vs. 9.7%), or general complications (7.1% vs. 9.6%) were found. The global mortality in the first 30 days after surgery was .7%. An ASA score of III-IV and surgery duration longer than 3 hours were identified as independent prognostic factors for early complications. Conclusions: Preoperative chemoradiation in patients with rectal cancer treated with surgery is not associated with a higher incidence of early postoperative complications. The patient~s preoperative clinical condition and lengthy surgery time are prognostic factors for early complications.

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Long-term results of a randomised trial of short-course low-dose adjuvant pre-operative radiotherapy for rectal cancer: Reduction in local treatment failure

Cited by 256 publications

References 23 publications

Importance of tumor regression assessment in predicting the outcome in patients with locally advanced rectal carcinoma who are treated with preoperative radiotherapy

Importance of tumor regression assessment in predicting the outcome in patients with locally advanced rectal carcinoma who are treated with preoperative radiotherapy

Recent advances in the management of radiation colitis

Analysis of Early Postoperative Morbidity Among Patients with Rectal Cancer Treated with and without Neoadjuvant Chemoradiotherapy

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