Assuntos
Radioterapia Adjuvante/métodos , Neoplasias Retais , Humanos , Invasividade Neoplásica , Recidiva Local de Neoplasia/prevenção & controle , Estadiamento de Neoplasias , Avaliação de Resultados em Cuidados de Saúde , Seleção de Pacientes , Prognóstico , Neoplasias Retais/patologia , Neoplasias Retais/radioterapia , Neoplasias Retais/cirurgiaRESUMO
Spread of the tumor in the distal direction is an important factor that must be considered when performing organ-serving surgery for rectal cancer. Particular relevance it has acquired in recent years due to the general tendency to expand the indications for the preservation of natural reflex-apparatus in patients with medium- and lower-ampullar part of the rectum.
Assuntos
Canal Anal , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Tratamentos com Preservação do Órgão , Neoplasias Retais/patologia , Neoplasias Retais/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/tendências , Humanos , Recidiva Local de Neoplasia/prevenção & controle , Tratamentos com Preservação do Órgão/métodos , Neoplasias Retais/prevenção & controleRESUMO
The objective of this study was to improve the immediate and long-term results of combined treatment of patients with locally advanced rectal cancer. The study included 128 patients with morphologically confirmed diagnosis and clinical stage cT3/T4 and N-/N+, treated from 1998 to 2009. The comparison group had 64 patients, combined treatment included prolonged preoperative radiotherapy 4 Gy and 40 Gy, surgery was performed after 4 weeks. In the study group--also 64 patients--combined treatment consisted of preoperative chemoradiotherapy (continuous a-120 hour infusion of 5-fluorouracil at a dose of 500 mg/m2 in the first and last week of radiotherapy in 2 Gy to 50 Gy), surgery was performed through 6 weeks after chemoradiotherapy. Excision of the primary tumor was performed in 40 (62.5%) patients in the control group and in 53 (82.8%) patients in the study group. Wherein R-0 resections were performed in 32 (67%) patients and in 41 (73%), and R-1 resections--in 1 (2%) patients, and 7 (13%) patients in the control and study groups respectively. A 5-year survival rate was 43.6 ± 7.2% control and 62.7 ± 5.1 % in the study group.
Assuntos
Adenocarcinoma/patologia , Adenocarcinoma/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimiorradioterapia Adjuvante , Terapia Neoadjuvante/métodos , Neoplasias Retais/patologia , Neoplasias Retais/terapia , Adenocarcinoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Esquema de Medicação , Feminino , Fluoruracila/administração & dosagem , Seguimentos , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante/efeitos adversos , Estadiamento de Neoplasias , Neoplasias Retais/cirurgia , Análise de Sobrevida , Fatores de Tempo , Resultado do TratamentoRESUMO
The pathomorphism of rectal cancer (RC) was studied in 99 patients who received neoadjuvant chemoradiotherapy using two drugs (5-fluorouracil and xeloda). A morphological study indicated the qualitatively similar manifestations of pathomorphism (tumor necrosis, inflammation, and sclerosis) which were more pronounced in the use of xeloda. Three degrees of the pathomorphism of RC have been identified: the tumor was unchanged, changed, and undetectable.
Assuntos
Desoxicitidina/análogos & derivados , Fluoruracila/análogos & derivados , Fluoruracila/administração & dosagem , Terapia Neoadjuvante , Neoplasias Retais/tratamento farmacológico , Adulto , Capecitabina , Proliferação de Células/efeitos dos fármacos , Quimiorradioterapia , Desoxicitidina/administração & dosagem , Desoxicitidina/efeitos adversos , Feminino , Fluoruracila/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Retais/patologia , Neoplasias Retais/radioterapiaAssuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Procedimentos Cirúrgicos do Sistema Digestório , Neoplasias Retais/terapia , Algoritmos , Quimioterapia Adjuvante , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Fracionamento da Dose de Radiação , Esquema de Medicação , Fluoruracila/administração & dosagem , Seguimentos , Humanos , Hipertermia Induzida , Leucovorina/administração & dosagem , Radioterapia Adjuvante/efeitos adversos , Neoplasias Retais/tratamento farmacológico , Neoplasias Retais/patologia , Neoplasias Retais/radioterapia , Neoplasias Retais/cirurgia , Estudos Retrospectivos , Análise de Sobrevida , Resultado do TratamentoRESUMO
Morphogenesis of tumour lesions produced by photodynamic therapy (PDT) includes a direct cytotoxic effect, lesions due to the disturbance of microcirculation, lesions by the activated inflammatory cells and cytokines released by these cells (tumour necrosis factor, histamine, prostaglandins). Ultrastructurally, the cell death is due to the cell membrane and nucleus apparatus damage by active oxygen forms and biomolecular radicals.