Preoperative radiation therapy for rectal carcinoma

Roe, John P.; Kodner, Ira J.; Walz, Bruce J.; Fry, Robert D.

doi:10.1007/bf02553659

Cited by 24 publications

(1 citation statement)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When discussing the role of radiotherapy in the conservative management of rectal cancer, it is essential to remember that many authors (Wang and Schutz [19], Bugat and coworkers [20], Roe and associates [21], Cummings [22], Marks and colleagues [23], and especially Pahlman and Glimelius [24]) report that pre-operative external beam irradiation is more effective in reducing the incidence of local recurrence than postoperative radiotherapy and that some tumors may be controlled by irradiation alone if the dose of radiation is appropriate and if there is a waiting period before surgery. In our own series mentioned above, the 21 patients with tumorfree specimens could theoretically have been spared major surgery and some of the 14 patients with Dukes' A microresidual disease might have been treated conservatively by a boost dose of endocavitary irradiation to the tumor bed.…”

Section: Endocavitary Irradiation Combined With External Beam Irradia...mentioning

confidence: 99%

Endocavitary irradiation in the conservative treatment of adenocarcinoma of the low rectum

Papillon

Berard

1992

World j. surg.

View full text Add to dashboard Cite

Early T1 and small T2 low rectal cancers may be controlled by endocavitary irradiation using the 50 kV Philips machine. The ambulatory treatment performed in the out-patient department consists of 4 applications within 6 weeks. Iridium-192 implant performed under local anesthesia is useful in many cases to give a booster dose to the tumor bed. In a series of 312 patients followed for greater than 5 years, the rates of local and nodal failure were 4.5% and 3.8%, respectively. The rate of death from cancer was 7.7%. After local excision endocavitary irradiation may be used as adjuvant therapy but it is safer to combine external beam and endocavitary irradiation. In the particular case of very poor risk patients with T2 or T3 tumors of the lower third of the rectum, a short course of external beam irradiation (30 Gy within 12 days) followed 2 months later by endocavitary irradiation may be a reliable procedure to prevent permanent colostomy in cases selected according to the patient's condition and the features of the residual disease. Of 67 patients followed for greater than 5 years, 3 patients died of distant metastasis and 5 patients died of local failures. These data, based on close collaboration with surgeons, suggest a reappraisal of the role of radiation therapy in the conservative management of rectal cancer.

show abstract

Section: Endocavitary Irradiation Combined With External Beam Irradia...mentioning

confidence: 99%

Endocavitary irradiation in the conservative treatment of adenocarcinoma of the low rectum

Papillon

Berard

1992

World j. surg.

View full text Add to dashboard Cite

show abstract

Survival following moderate-dose preoperative radiation therapy for carcinoma of the rectum

Friedmann¹,

Garb²,

Park³

et al. 1985

Cancer

View full text Add to dashboard Cite

We performed a retrospective study of patients with carcinoma of the rectum or rectosigmoid undergoing surgical resection. Forty‐two patients received adjuvant preoperative radiation therapy (4000–4500 rad). One hundred twenty patients underwent surgical resection alone. Survival of radiation patients was significantly improved over that of Surgery Only patients, even after adjusting for nontreatment factors using Cox regression. Crude 5‐year survival was 63% for radiation patients (74% adjusted) compared to 46% for surgery‐only patients (48% adjusted) (P < 0.025). Radiation patients also had longer disease‐free survival than surgery‐only patients (P < 0.05) and fewer recurrences (14% versus 37%; P < 0.025). Fewer radiation patients had lymph nodes involved with tumor than surgery‐only patients (20% versus 35%; P = 0.07). Although 71% of radiation patients experienced radiation reactions, these were primarily mild and transitory. We believe that preoperative radiation is an effective and safe adjunct to surgery in the treatment of rectal cancer and that its use can lead to improved survival rates.

show abstract

Rectal carcinoma. Long-term experience with moderately high-dose preoperative radiation and low anterior resection

Kerman

Roberson

Bloom

et al. 1992

Cancer

View full text Add to dashboard Cite

This report updated an analysis of a 14‐year experience of moderately high‐dose (4500 to 5000 cGy) preoperative radiation as an adjuvant to low anterior resection of 95 cases of adenocarcinoma of the rectum. The treatment was well tolerated without treatment‐related mortality and with a low incidence (5.2%) of severe complications. The local recurrence rate was 4.2%, and distant failure rate was 10.5%. At 5 years, the actuarial survival rate was 66% and the disease‐free survival rate was 64%. At 10 years, the actuarial survival rate and disease‐free survival rate were 52%. The authors concluded that moderately high‐dose (4500 to 5000 cGy) neoadjuvant radiation in clinically resectable adenocarcinoma of the rectum in which one segment of the anastomosis was in the preoperative radiation field is a safe, effective adjuvant to low anterior resection and that it offered patients excellent local control, long‐term survival, and sphincter preservation. Results could be enhanced by chemotherapy, and the authors urged well‐designed prospective randomized multicenter trials to determine the most appropriate drugs, dosage, and sequencing of co‐adjuvant preoperative radiation therapy and chemotherapy with surgery.

show abstract

Preoperative radiation therapy for rectal carcinoma

Cited by 24 publications

References 10 publications

Endocavitary irradiation in the conservative treatment of adenocarcinoma of the low rectum

Endocavitary irradiation in the conservative treatment of adenocarcinoma of the low rectum

Survival following moderate-dose preoperative radiation therapy for carcinoma of the rectum

Rectal carcinoma. Long-term experience with moderately high-dose preoperative radiation and low anterior resection

Contact Info

Product

Resources

About