Regional hyperthermia added to intensified preoperative chemo-radiation in locally advanced adenocarcinoma of middle and lower rectum.
Int J Hyperthermia
; 26(2): 108-17, 2010.
Article
em En
| MEDLINE
| ID: mdl-20146565
ABSTRACT
PURPOSE:
To evaluate the safety of delivering pre-operative regional hyperthermia (HT) plus an intensified chemo-radiotherapy (CRT) regimen in patients suffering from locally advanced rectal cancer.METHODS:
Between June 2000 and April 2006, 76 patients with locally advanced (cT3-4 N0/+) rectal adenocarcinoma were treated with HT plus CRT. HT was given once a week, to a total of five treatments, 1 to 4 h after radiotherapy (50 Gy with 2-Gy fractions for 5 weeks, plus a 10-Gy boost on the tumour bed, with the same fractionation schedule). Chemotherapy consisted in 5FU 200 mg/m(2) continuous infusion throughout the 6 weeks of irradiation and OXA 45 mg/m(2) in a weekly bolus. Surgery followed 4 to 6 weeks after the completion of HT plus CRT.RESULTS:
HT plus CRT was generally well tolerated. At pathologic examination, there was a pathologic complete response (pCR) (ypT0 ypN0) in 18 out of 76 patients (23.6%), a partial response (PR) in 34/76 ones (44.7%) and a stable disease (SD) in 20/76 (26.3%) ones; 4/76 patients (5.2%) had a progression disease (PD) (distant metastases) at the time of surgery. Good predictors of a longer disease-free survival (DFS) were in order ypN status (log-rank test p = 0.0008), ypT status (p = 0.002) and pCR (p = 0.03).CONCLUSION:
Preoperative CRT combined with regional HT yielded acceptable toxicity. The rate of pCR was encouraging, although further studies are needed to prove the long-term efficacy of adding HT to CRT.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Retais
/
Cuidados Pré-Operatórios
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Adenocarcinoma
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Quimioterapia Adjuvante
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Radioterapia Adjuvante
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Terapia Neoadjuvante
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Hipertermia Induzida
Tipo de estudo:
Prognostic_studies
Limite:
Adult
/
Aged
/
Aged80
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Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Int J Hyperthermia
Assunto da revista:
NEOPLASIAS
/
TERAPEUTICA
Ano de publicação:
2010
Tipo de documento:
Article