Complications following postoperative combined radiation and chemotherapy in adenocarcinoma of the rectum and rectosigmoid: A randomized trial that failed

Sparsø, Bo Hempel; Maase, Hans von der; Kristensen, Dan; Christiansen, John; Nielsen, Svend Å. Damgaard; Hebjørn, M; Andersen, Bjørn

doi:10.1002/1097-0142(19841201)54:11<2363::aid-cncr2820541110>3.0.co;2-u

Cited by 21 publications

(3 citation statements)

References 13 publications

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“…It is well known that RT may be a cause of intra‐abdominal adhesion formation [25]. Many reports regarding irradiation complications including bowel obstruction have been published [11–15,25–28]. According to these studies, the rate of bowel obstruction due to intra‐abdominal adhesions ranges from 4.9% to 38.5%.…”

Section: Discussionmentioning

confidence: 99%

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Prevention of intra‐abdominal adhesions by using Seprafilm^® in rats undergoing bowel resection and radiation therapy

Eroğlu

Demirci

Kurtman³

et al. 2001

Colorectal Disease

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Objective Intra-abdominal adhesions are an important surgical problem. Colorectal operations are a major cause of adhesive obstruction. Radiation therapy (RT) is frequently used as an adjuvant therapy to surgery for rectal cancer, though its value for colon carcinoma remains unclear. Peritoneal injuries including the surgical trauma, tissue ischaemia as well as RT are associated with peritoneal ®brinolytic activity. A sodium hyaluronate and carboxymethylcellulose bioresorbable membrane (Sepra-®lm Ò ) has been used to reduce intra-abdominal adhesion formation. We have investigated the effect of Sepra®lm Ò on intra-abdominal adhesion in rats receiving RT after the resection of the left colon.Materials and methods Thirty-two male Wistar rats were divided into two groups: group 1 (n 16), control (colon resection, no Sepra®lm Ò ); group 2 (n 16), study group (colon resection and Sepra®lm Ò ). All the rats received 50 Gy RT after left colon resection. Intraabdominal adhesions were evaluated by grading and measurement of tissue-type plasminogen activator (tPA) as a tissue adhesion marker in peritoneal samples from the rats. tPA was determined using a commercially available ELISA kit. ResultsThe levels of tPA were signi®cantly increased in group 2 rats compared with those in the control group (P 0.0276). It was also seen that adhesions in the rats receiving Sepra®lm Ò were signi®cantly less severe than those in the control group.Conclusion Our ®ndings suggest that the intraperitoneal administration of Sepra®lm Ò reduced the frequency and strength of adhesions.

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Section: Discussionmentioning

confidence: 99%

“…It is well known that the colorectal procedure is a major cause of adhesive intestinal obstruction. Moreover, it has been reported that the risk of bowel obstruction is higher in patients receiving adjuvant RT than in those undergoing only surgical resection [11–14]. Montz et al .…”

Section: Introductionmentioning

confidence: 99%

Prevention of intra‐abdominal adhesions by using Seprafilm^® in rats undergoing bowel resection and radiation therapy

Eroğlu

Demirci

Kurtman³

et al. 2001

Colorectal Disease

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“…Dve velike studije, jedna u Danskoj i druga u Holandiji u kojima je primenjen protrahovani režim preoperativne standradno frakcio-nisane terapije zračenjem pokazale su značajno smanjenje lokalnog recidiva u odnosu na kontrolnu grupu bolesnika kod kojih je lečenje bilo isključivo hirurško, uz značajno produženje DFI intervala i s neznatno manjim procentom perioperativnog mortaliteta i morbiditeta, u odnosu na prethodno prijavljene [18,19].…”

Section: Preporuke Za Selekciju Bolesnika Za Primenu Neoadjuvantne Teunclassified

Importance of neoadjuvant treatment in management of locally advanced rectal cancer

Vasić¹

2018

Biomedicinska istraž.

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Neoadjuvantni pristup (preoperativna primena terapije zračenjem i hemioterapije)u lečenju lokalno uznapredovalog karcinoma rektuma doveo jedo značajnog poboljšanja lokalne kontrole bolesti smanjenjem procentalokalnih recidiva i poboljšanja kvaliteta života jer je povećan broj sfinkterpoštednih resekcija, ali nije uticao na promenu ukupnog preživljavanja bolesnika.U lečenju lokalno uznapredovalog karcinoma rektuma preporuke uizboru bolesnika za ovaj vid lečenja zasnivaju se na nezavisnim prognostičkimfaktorima: stadijum bolesti (veličina tumora, limfni nodusi, inflitracijamezorektalne fascije) i lokalizacija tumora u odnosu na anokutanu liniju.Navedeni prognostički faktori ukazuju na rizik od razvoja lokalnog recidivačiju verovatnoću smanjuje neoadjuvantno lečenje uz sfinkter poštednuresekciju sa ciljem poboljšanja kvaliteta života. Uspeh neoadjuvantnog lečenjauslovljen je: modalitetom i tehnikom radioterapijskog tretmana, vremenomizvođenja resekcije primarnog tumora i biologijom tumora. Otkrićamehanizama kancerogeneze kolorektalnih karcinoma pruža nadu da ćemolekularna terapija uz nove tehnike zračenja obezbediti bolji odgovor napreoperativno lečenje i time odrediti izbor adjuvantne terapije u cilju postizanjadužeg preživljavanja bolesnika. Kliničke studije koje su u toku pružićeodgovore na ova pitanja.

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Toxicity associated with adjuvant postoperative therapy for adenocarcinoma of the rectum

Thomas¹,

Lindblad²,

Stablein³

et al. 1986

Cancer

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The Gastrointestinal Tumor Study Group's (GITSG) adjuvant rectal carcinoma study compared four postoperative treatment regimens: (1) control (no adjuvant therapy); (2) chemotherapy alone consisting of pulses of 5-fluorouracil and methyl CCNU for 18 months; (3) pelvic and perineal radiotherapy using parallel opposed fields with 4000 rad in 4.5 to 5 weeks or 4800 rad in 5 to 5.5 weeks; and (4) a combination of both modalities. The results of this study are published elsewhere and show a significantly reduced recurrence rate and prolonged disease-free survival time for the combined modality arm compared with the no therapy arm. Severe toxicity in the combined therapy arm was significantly worse (P less than 0.001) than in either single modality arm. Most of the differences in toxicity experienced between the three regimens involved diarrhea, thrombocytopenia, and leukopenia. Analysis of all parameters of radiotherapy quality assurance data was not significantly associated with toxicity. Radiation enteritis was noted in 5 patients of 96 (5.2%) in the two arms containing irradiation. All five required laparotomy. The two enteritis fatalities occurred late at 605 and 1000 days after start of combined modality treatment, respectively. One other patient on the chemotherapy arm died of acute nonlymphocytic leukemia. The authors conclude that combined radiotherapy and chemotherapy, although significantly more effective in reducing recurrence than no therapy, is significantly more toxic than single-modality therapy in many parameters, although most of the toxicity is transient and therefore not limiting. Late complications, which are less reversible and therefore much more important than early reactions, and radiation enteritis in this study were relatively uncommon. This schedule of combined modality therapy is not only effective but appears to have tolerable toxicity, because of the relative lack of late effects.

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Complications following postoperative combined radiation and chemotherapy in adenocarcinoma of the rectum and rectosigmoid: A randomized trial that failed

Cited by 21 publications

References 13 publications

Prevention of intra‐abdominal adhesions by using Seprafilm^® in rats undergoing bowel resection and radiation therapy

Prevention of intra‐abdominal adhesions by using Seprafilm^® in rats undergoing bowel resection and radiation therapy

Importance of neoadjuvant treatment in management of locally advanced rectal cancer

Toxicity associated with adjuvant postoperative therapy for adenocarcinoma of the rectum

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Complications following postoperative combined radiation and chemotherapy in adenocarcinoma of the rectum and rectosigmoid: A randomized trial that failed

Cited by 21 publications

References 13 publications

Prevention of intra‐abdominal adhesions by using Seprafilm® in rats undergoing bowel resection and radiation therapy

Prevention of intra‐abdominal adhesions by using Seprafilm® in rats undergoing bowel resection and radiation therapy

Importance of neoadjuvant treatment in management of locally advanced rectal cancer

Toxicity associated with adjuvant postoperative therapy for adenocarcinoma of the rectum

Contact Info

Product

Resources

About

Prevention of intra‐abdominal adhesions by using Seprafilm^® in rats undergoing bowel resection and radiation therapy

Prevention of intra‐abdominal adhesions by using Seprafilm^® in rats undergoing bowel resection and radiation therapy