Five- Year Results of a Prospective and Randomized Study: Experience with Combined Radiotherapy and Surgery of Primary Rectal Carcinoma

Niebel, W.; Schulz, Ulrich; Ried, Michael; Erhard, J; Beersiek, F; Blöcher, G; Nier, H; Halama, H; Scherer, E; Zeller, Georg

doi:10.1007/978-3-642-83293-2_16

Cited by 12 publications

(5 citation statements)

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“…Four of the 19 trials of preoperative RT compared with surgery alone were excluded from the review [12-15]. Preliminary results of one trial have been reported in Russian [12], but the report and results were difficult to interpret.…”

Section: Resultsmentioning

confidence: 99%

“…This trial was excluded until more mature results are available and it is clear that the trial meets the inclusion criteria. Three trials [13-15] had major violations to the inclusion criteria. The Memorial Hospital trial included both randomized as well as non-randomized patients in the analysis [13].…”

Section: Resultsmentioning

confidence: 99%

“…The Veterans Administration Surgical Oncology Group (VASOG) Trial I included patients who may have had apparent metastases and did not allow for an analysis excluding this group of patients [14]. The Essen trial was described in summary form and was a failed trial of preoperative plus postoperative RT treatment due to difficulties with compliance [15]. The remaining 15 trials are shown in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…The CCCG search yielded 19 trials of preoperative RT which included five trials not included in our review: two trials using preoperative plus postoperative RT [15,31], one trial including patients with metastatic disease [14], another combining RT with 5-fluorouracil (5-FU) administration [33] and a Japanese trial published in 1989. Analysis was done by the log-rank method for overall and disease-specific mortality and for all and isolated recurrences.…”

Section: Resultsmentioning

confidence: 99%

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The use of preoperative radiotherapy in the management of patients with clinically resectable rectal cancer: a practice guideline

Figueredo

Zuraw

Wong

et al. 2003

BMC Med

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BackgroundThis systematic review with meta-analysis was designed to evaluate the literature and to develop recommendations regarding the use of preoperative radiotherapy in the management of patients with resectable rectal cancer.MethodsThe MEDLINE, CANCERLIT and Cochrane Library databases, and abstracts published in the annual proceedings of the American Society of Clinical Oncology and the American Society for Therapeutic Radiology and Oncology were systematically searched for evidence. Relevant reports were reviewed by four members of the Gastrointestinal Cancer Disease Site Group and the references from these reports were searched for additional trials. External review by Ontario practitioners was obtained through a mailed survey. Final approval of the practice guideline report was obtained from the Practice Guidelines Coordinating Committee.ResultsTwo meta-analyses of preoperative radiotherapy versus surgery alone, nineteen trials that compared preoperative radiotherapy plus surgery to surgery alone, and five trials that compared preoperative radiotherapy to alternative treatments were obtained. Randomized trials demonstrate that preoperative radiotherapy followed by surgery is significantly more effective than surgery alone in preventing local recurrence in patients with resectable rectal cancer and it may also improve survival. A single trial, using surgery with total mesorectal excision, has shown similar benefits in local recurrence.ConclusionFor adult patients with clinically resectable rectal cancer we conclude that:• Preoperative radiotherapy is an acceptable alternative to the previous practice of postoperative radiotherapy for patients with stage II and III resectable rectal cancer;• Both preoperative and postoperative radiotherapy decrease local recurrence but neither improves survival as much as postoperative radiotherapy combined with chemotherapy. Therefore, if preoperative radiotherapy is used, chemotherapy should be added postoperatively to at least patients with stage III disease.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

The use of preoperative radiotherapy in the management of patients with clinically resectable rectal cancer: a practice guideline

Figueredo

Zuraw

Wong

et al. 2003

BMC Med

View full text Add to dashboard Cite

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“…The Swedish school also encouraged ''short-term,'' high-dose (5 Gy split/d for 5 days) RT to achieve a whole dose of 25 Gy, followed by surgery, not later than 1 week (11). A number of trials have evaluated these different preoperative RT schedules followed by surgery versus surgery alone in patients with rectal cancer (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). At least three meta-analyses have explored the benefit of preoperative RT (29)(30)(31).…”

Section: Introductionmentioning

confidence: 99%