کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
5526309 | 1547060 | 2017 | 13 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: Original ResearchOrgan or sphincter preservation for rectal cancer. The role of contact X-ray brachytherapy in a monocentric series of 112 patients Original ResearchOrgan or sphincter preservation for rectal cancer. The role of contact X-ray brachytherapy in a monocentric series of 112 patients](/preview/png/5526309.png)
- Contact X-ray Brachytherapy (CXB) is a unique technique safe and efficient of endoscopic irradiation for rectal cancer.
- CXB with chemo radiotherapy can safely escalate the dose and provide organ preservation in selected rectal cancers.
- The European OPERA randomized trial should bring evidence for organ preservation using CXB in rectal cancer.
BackgroundContact X-ray brachytherapy (CXB) has been used at Centre Antoine Lacassagne since 2002 to increase the chance of conservative treatment (organ or sphincter preservation) in rectal cancer. A consecutive series of 112 patients (pts) is reported.MethodsThree protocols were used in selected rectal adenocarcinomas. Group 1: T1 N0 treated with local excision (LE) followed by adjuvant CXB. Group 2: T2 or 'early' T3 N0 treated with CXB combined with chemoradiotherapy (CRT) followed by surveillance or LE. Group 3: distal 'locally advanced' T3 N0-2 treated with CXB and CRT before total proctectomy.ResultsGroup 1: 27Â pt (pTis: 3; pT1: 21; pT2: 3). After LE with CXB alone (20Â pt) or CXBÂ +Â CRT (7Â pt) one local recurrence occurred. Organ preservation was achieved in 26Â pt (96%). Group 2: 45Â pt (T1: 2; T2: 23; T3: 20) treated with CXB alone (4Â pt) or CXBÂ +Â CRT or external beam radiotherapy (EBRT) (41Â pt). A clinical complete response (cCR) was observed in 43/45 (96%) and 3Â pt developed a local recurrence (11% at 5 years). The specific survival was 76% at 5 years and the rate of organ preservation was 89% (40/45Â pt) with good bowel function in 36Â pt. Group 3: 40Â pt, anterior resection (with sphincter preservation) was possible in 35Â pt (86%) with a 3-year local recurrence of 6%.ConclusionCXB usually combined as a boost with CRT or EBRT may safely increase the chance of a conservative treatment (organ or sphincter preservation) for selected rectal cancers.
Journal: European Journal of Cancer - Volume 72, February 2017, Pages 124-136