Acute Side Effects and Complications After Short-Term Preoperative Radiotherapy Combined With Total Mesorectal Excision in Primary Rectal Cancer: Report of a Multicenter Randomized Trial

Abstract

Preoperative hypofractionated RT is a safe procedure in patients treated with TME surgery, despite a slight increase in complications when compared with TME surgery only.

CPT-11 and concomitant hyperfractionated accelerated radiotherapy induce efficient local control in rectal cancer patients: results from a phase II

“…It has been described to occur in about 1/3 of the patients (Pahlman and Glimelius, 1990;Kapiteijn et al, 2001;Marijnen et al, 2002). In the present series, the duration of perineal wound healing was prolonged in more than half of the patients who underwent APR.…”

“…It has been reported that 20 -35% of the patients develop diarrhoea Xgrade 2 when treated with a conventional radiotherapy technique using large irradiation fields (Minsky et al, 1995;Bosset et al, 2004). The overall incidence of postoperative complications is 27% and is in the range of what has been observed with 5FU-based protocols (Swedish Rectal Cancer Trial, 1997;Rodel et al, 2000;Ngan et al, 2001;Marijnen et al, 2002;Mehta et al, 2003;Bosset et al, 2004). Recently, the large randomised German trial on chemoradiotherapy reported a 36% postoperative complication rate (Table 5) (Sauer et al, 2004).…”

“…Recently, the large randomised German trial on chemoradiotherapy reported a 36% postoperative complication rate (Table 5) (Sauer et al, 2004). The rate of anastomotic leakage (AL) after low anterior resection and TME is usually in the range of 6 -18% depending on the series and whether protective ileostomy has been applied or not (Swedish Rectal Cancer Trial, 1997;Rodel et al, 2000;Marijnen et al, 2002;Mehta et al, 2003;Sauer et al, 2004). The AL rate of 6% in our trial compares favourably and indicates that the administration of neoadjuvant CPT-11 with radiotherapy is safe.…”

Tumor response is predicted by patient genetic profile in rectal cancer patients treated with neo-adjuvant chemo-radiotherapy

“…In fact, neo-adjuvant treatment followed by standard surgery is time consuming, expensive and increases perioperative morbidity. 8,16 Host genetic variability has been recently shown to represent a key component in the personalization of cancer chemo-radiation particularly in the neo-adjuvant treatment of locally advanced rectal cancer. [17][18][19] A majority of the pharmacogenetic studies focus on a single candidate gene, which is assumed to be strongly associated with the clinical outcome of the drug.…”

Rectal cancer irradiation. Long course, short course or something else?

“…Acute toxicity was, as expected low, but one patient had to stop therapy due to nausea and vomiting (virtually never seen after 5 )/5 Gy [29,30], and two (10%) died postoperatively. This figure is much higher than otherwise seen (2Á4%), but could be caused by chance.…”