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Preoperative short-term radiation therapy (25 Gy, 2.5 Gy twice daily) for primary resectable rectal cancer (phase II)

机译:原发性可切除直肠癌的术前短期放疗(25yGy,每天两次2.5 Gy)(II期)

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摘要

To evaluate the feasibility, effectiveness, and long-term bowel function of preoperative hyperfractionated accelerated radiotherapy in primary resectable rectal cancer. A total of 184 consecutive patients (median age 65 years, male : female=2 : 1) with clinical T3Nx rectal adenocarcinoma received preoperative pelvic radiation therapy with single fractions of 2.5 Gy twice daily (interval 6 h between fractions) to a total dose of 25 Gy within 1 week. Surgery was conducted the following week. Postoperative histology revealed UICC stage I in 33%, stage II in 26%, stage III in 34%, and stage IV in 7% of the patients. Median follow-up was 43 months (53 months for surviving patients). The actuarial 4-year-local-recurrence rate was 2.1%, overall recurrence 23%. Disease-specific and disease-free survivals at 4 years (excluding stage IV) were 82 and 69%, respectively. Overall survival for 4 years was 68%. Postoperative mortality was 0.5% (one patient), early anastomotic leakage occurred in 11.4%, and anastomotic stenosis requiring treatment in 6%, of 132 patients with primary anastomosis. Seven of 184 patients (3.8%) died of abdominal complications, all within the first year. Bowel function was satisfactory after more than 5 years. Local control in primarily resectable rectal cancer after 10 × 2.5 Gy is excellent, warranting further evaluation of this treatment.
机译:评估术前超分割加速放疗在原发性可切除直肠癌中的可行性,有效性和长期肠功能。总共184例临床T3Nx直肠腺癌连续患者(中位年龄为65岁,男:女= 2:1)接受术前盆腔放疗,单次2.5 Gy的剂量每天两次(两次之间的间隔6 h),总剂量为1周内25 Gy。下周进行手术。术后组织学检查显示,UICC I期患者为33%,II期患者为26%,III期患者为34%,IV期患者为7%。中位随访时间为43个月(存活患者为53个月)。精算的4年局部复发率为2.1%,总复发率为23%。 4年(不包括IV期)的疾病特异性和无病生存率分别为82%和69%。 4年总生存率为68%。 132例原发性吻合术患者的术后死亡率为0.5%(一名患者),早期吻合口漏发生率为11.4%,需要治疗的吻合口狭窄为6%。 184名患者中有7名(3.8%)在第一年内死于腹部并发症。超过5年后肠功能令人满意。 10×2.5 Gy后主要可切除的直肠癌的局部控制非常好,因此有必要对该治疗进行进一步评估。

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