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首页> 外文会议>St. Gallen EORTC Gastrointestinal Cancer Conference >Early and Late Toxicity of Radiotherapy for Rectal Cancer
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Early and Late Toxicity of Radiotherapy for Rectal Cancer

机译：直肠癌放射治疗的早期和晚期毒性

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With the implementation of total mesorectal excision surgery and neoadjuvant (chemo) radiotherapy, the outcome of rectal cancer patients has improved and a substantial proportion of them have become long-term survivors. These advances come at the expense of radiation- and chemotherapy-related toxicity which remains an underestimated problem. Radiation-induced early toxicity in rectal cancer treatment mainly includes diarrhea, cystitis, and perineal dermatitis, while bowel dysfunction, fecal incontinence, bleeding, and perforation, genitourinary dysfunction, and pelvic fractures constitute the majority of late toxicity. It is now generally accepted that short-course radiotherapy (SCRT) and immediate surgery is associated with less early toxicity compared to conventionally fractionated chemoradiotherapy with delayed surgery. There are no significant differences in late toxicity between both treatment regimens. While there is hardly an increase in early toxicity after preoperative SCRT with immediate surgery, late toxicity is substantial compared to surgery alone. Early toxicity is more frequent when a longer interval between SCRT and surgery is used and is comparable to the toxicity observed with conventionally fractionated radiotherapy except that it occurs after the end of the radiotherapy. So far, randomized phase III trials failed to demonstrate a substantial gain in tumoural response when oxaliplatin or molecular agents are added to the multimodality treatment. Moreover, the addition of these drags increases toxicity and remains therefore experimental.
机译：随着总切除切除手术和Neoadjuvant（Chemo）放射治疗的实施，直肠癌患者的结果有所改善，其大部分已成为长期幸存者。这些进展是以辐射和化疗相关的毒性为代价，这仍然是低估的问题。辐射诱导的直肠癌治疗的早期毒性主要包括腹泻，膀胱炎和会阴皮炎，而肠功能障碍，粪便失禁，出血和穿孔，养育功能障碍和骨盆骨折构成大多数晚期毒性。目前普遍认为，与延迟手术的常规分级化学疗法相比，短期疗程放射治疗（SCRT）和即时手术与早期毒性较少。两种治疗方案之间的晚期毒性没有显着差异。虽然在术前瘢痕出现时几乎没有提高早期毒性，但直接手术后，与单独的手术相比，晚期毒性很大。当使用瘢痕和手术之间的更长间隔并且与常规分级放射疗法观察的毒性相当时，早期毒性更频繁频繁。除了它在放射疗法结束后发生。到目前为止，随机期III试验未能在向多模态处理中加入奥克洛铂或分子试剂时表现出巨大的巨大增益。此外，添加这些阻力增加了毒性，因此仍然存在实验性。

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