Local recurrence used to be a major problem in rectal cancer treatment, with local recurrence rates varying from 20% to 45%. Preoperative short-term radiotherapy has shown to improve local control and survival in combination with conventional surgery. With the introduction of total mesorectal excision, the number of local recurrences has reduced dramatically. The additional value of preoperative radiotherapy, either given as a short course (SCRT, 5x5 Gy followed by immediate surgery) or as conventional chemo-radiotherapy (CRT, 25 x 1.8 or 2.0 Gy combined with 5-FU based chemotherapy), further improved local control to an extent, that this is no longer the major problem in rectal cancer treatment. However, with overall 5-year survival rates of 65% to 70%, distant metastases still are a challenge in the treatment of rectal cancer. In this manuscript, the value of the different types of preoperative radiotherapy will be discussed, as well as the possibility to use the 5x5 Gy regimen for improvement of overall survival.
展开▼
机译:局部复发曾经是直肠癌治疗中的一个主要问题,局部复发率从20%到45%变化。术前短期放射治疗表明,与常规手术组合改善局部对照和生存。随着引入总培素切除的,局部复发的数量急剧下降。术前放射治疗的额外值,作为短期路线(SCRT,5x5 GY,然后立即外科)或作为常规化疗(CRT,25 x 1.8或2.0Gy与5-Fu基化疗结合),进一步改善局部控制在一定程度上,这不再是直肠癌治疗中的主要问题。然而,总体5年生存率为65%至70%,远处转移仍然是治疗直肠癌的挑战。在这份手稿,不同类型的术前放疗的价值将被讨论,以及使用5×5戈瑞方案改善总体生存的可能性。
展开▼