Combined treatment of rectal cancer with moderate risk of tumor progression
OBJECTIVE: To increase the effectiveness of combined treatment in patients with rectal cancer and moderate risk of progression based on the concept of polyradiomodification (PRM).
MATERIAL AND METHODS: The study included 337 patients with rectal cancer and moderate risk of tumor progression. A short course of radiotherapy (cRT) (5x5 Gy) combined with several radiomodifiers (cRT+PRM) was performed in 147 (43.6%) patients. Other 190 (56.4%) patients underwent cRT. The following radio modifiers were used: three-time application of local microwave hyperthermia (Yacht-3 or Yacht-4 devices), two-time intrarectal delivery of a biopolymer composition with Metronidazole before the 3rd and 5th irradiation sessions and two-week oral administration of Capecitabine (Xeloda) at a daily dose of 2.0 g/m2. Surgery was performed in 4-6 weeks after radiotherapy.
RESULTS: CRT+PRM program increased 5-year relapse-free survival up to 81.3% compared to 60.3% after cRT alone (p=0.0003) due to significant reduction of the incidence of cancer recurrence from 8.4% to 0.7% (p=0.0013). More effective local growth control expanded the indications for sphincter-sparing surgery. These procedures were performed in 89.1% and 70.5% of patients, respectively (p=0.00001). In the cRT+PRM group, sphincter-sparing surgery reduced incidence of cancer recurrence from 13.7% to 0.8% (p=0.0110), distant metastases - from 23.9% to 13.7% (p=0.00349).
CONCLUSION: Radiomodification in neoadjuvant radiotherapy is justified in patients with moderate risk of tumor progression, improves long-term results and increases the incidence of sphincter-sparing surgery.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2022 |
|---|---|
| Enthalten in: |
Khirurgiia - (2022), 12. Vyp. 2 vom: 09., Seite 36-43 |
| Sprache: |
Russisch |
|---|
| Weiterer Titel: |
Rezul'taty primeneniya kombinirovannogo metoda lecheniya bol'nykh rakom pryamoi kishki so srednim riskom progressirovaniya opukholevogo protsessa |
|---|
| Beteiligte Personen: |
Barsukov, Yu A [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Combined treatment |
|---|
| Anmerkungen: |
Date Completed 27.12.2022 Date Revised 30.12.2022 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.17116/hirurgia202212236 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM350741840 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM350741840 | ||
| 003 | DE-627 | ||
| 005 | 20231226045659.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2022 xx |||||o 00| ||rus c | ||
| 024 | 7 | |a 10.17116/hirurgia202212236 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1169.xml |
| 035 | |a (DE-627)NLM350741840 | ||
| 035 | |a (NLM)36562671 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a rus | ||
| 100 | 1 | |a Barsukov, Yu A |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Combined treatment of rectal cancer with moderate risk of tumor progression |
| 246 | 3 | 3 | |a Rezul'taty primeneniya kombinirovannogo metoda lecheniya bol'nykh rakom pryamoi kishki so srednim riskom progressirovaniya opukholevogo protsessa |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 27.12.2022 | ||
| 500 | |a Date Revised 30.12.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To increase the effectiveness of combined treatment in patients with rectal cancer and moderate risk of progression based on the concept of polyradiomodification (PRM) | ||
| 520 | |a MATERIAL AND METHODS: The study included 337 patients with rectal cancer and moderate risk of tumor progression. A short course of radiotherapy (cRT) (5x5 Gy) combined with several radiomodifiers (cRT+PRM) was performed in 147 (43.6%) patients. Other 190 (56.4%) patients underwent cRT. The following radio modifiers were used: three-time application of local microwave hyperthermia (Yacht-3 or Yacht-4 devices), two-time intrarectal delivery of a biopolymer composition with Metronidazole before the 3rd and 5th irradiation sessions and two-week oral administration of Capecitabine (Xeloda) at a daily dose of 2.0 g/m2. Surgery was performed in 4-6 weeks after radiotherapy | ||
| 520 | |a RESULTS: CRT+PRM program increased 5-year relapse-free survival up to 81.3% compared to 60.3% after cRT alone (p=0.0003) due to significant reduction of the incidence of cancer recurrence from 8.4% to 0.7% (p=0.0013). More effective local growth control expanded the indications for sphincter-sparing surgery. These procedures were performed in 89.1% and 70.5% of patients, respectively (p=0.00001). In the cRT+PRM group, sphincter-sparing surgery reduced incidence of cancer recurrence from 13.7% to 0.8% (p=0.0110), distant metastases - from 23.9% to 13.7% (p=0.00349) | ||
| 520 | |a CONCLUSION: Radiomodification in neoadjuvant radiotherapy is justified in patients with moderate risk of tumor progression, improves long-term results and increases the incidence of sphincter-sparing surgery | ||
| 650 | 4 | |a English Abstract | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a combined treatment | |
| 650 | 4 | |a long-term treatment outcomes | |
| 650 | 4 | |a radiomodifiers | |
| 650 | 4 | |a rectal cancer | |
| 650 | 4 | |a risk factors of progression | |
| 650 | 4 | |a therapeutic pathomorphosis | |
| 700 | 1 | |a Tkachev, S I |e verfasserin |4 aut | |
| 700 | 1 | |a Mamedli, Z Z |e verfasserin |4 aut | |
| 700 | 1 | |a Aliev, V A |e verfasserin |4 aut | |
| 700 | 1 | |a Vlasov, O A |e verfasserin |4 aut | |
| 700 | 1 | |a Perevoshchikov, A G |e verfasserin |4 aut | |
| 700 | 1 | |a Oltarzhevskaya, N D |e verfasserin |4 aut | |
| 700 | 1 | |a Korovina, M A |e verfasserin |4 aut | |
| 700 | 1 | |a Dudaev, Z A |e verfasserin |4 aut | |
| 700 | 1 | |a Ovchinnikova, A I |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Khirurgiia |d 1945 |g (2022), 12. Vyp. 2 vom: 09., Seite 36-43 |w (DE-627)NLM000042609 |x 0023-1207 |7 nnns |
| 773 | 1 | 8 | |g year:2022 |g number:12. Vyp. 2 |g day:09 |g pages:36-43 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.17116/hirurgia202212236 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2022 |e 12. Vyp. 2 |b 09 |h 36-43 | ||