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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Preoperative radiotherapy and local excision of rectal cancer with immediate radical re-operation for poor responders.
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Preoperative radiotherapy and local excision of rectal cancer with immediate radical re-operation for poor responders.

机译：术前放疗和直肠癌局部切除，对不良反应者立即进行彻底的再手术。

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BACKGROUND AND PURPOSE: To report an early analysis of prospective study exploring preoperative radiotherapy and local excision in rectal cancer. MATERIALS AND METHODS: Mucosa at tumour edges was tattooed. Patients with cT1-3N0 tumour <3-4 cm were treated with either 5x5Gy+4Gy boost (N=31) or chemoradiation (50.4Gy+5.4Gy boost, 1.8Gy per fraction+5-fluorouracyl and leucovorin; N=13). Thirteen patients from the short-course group were unfit for chemotherapy. The interval from radiation to full-thickness local excision was 6 weeks. The protocol called for conversion to a transabdominal surgery in case of ypT2-3 disease or positive margin. RESULTS: The postoperative complications requiring hospitalization were recorded in 9% of patients. The rate of pathological complete response was 41%. The rate of patients requiring conversion was 34%; however, 18% actually underwent conversion and the remaining 16% refused or were unfit. During the 14 months of median follow-up, local recurrence was detected in 7% of patients and all underwent salvage surgery. Of 19 patients in whom initially anterior resection was likely, 16% had abdominoperineal resection performed for a conversion or as a rescue procedure. CONCLUSION: Our study suggests that the short-course radiation prior to local excision is a treatment option for high-risk patients.
机译：背景与目的：报告对直肠癌术前放疗和局部切除术进行前瞻性研究的早期分析。材料与方法：将肿瘤边缘的粘膜进行纹身。 cT1-3N0肿瘤<3-4 cm的患者接受5x5Gy + 4Gy增强治疗（N = 31）或化学放疗（50.4Gy + 5.4Gy增强治疗，每部分1.8Gy + 5-氟尿嘧啶和亚叶酸钙; N = 13）。短疗程组的13名患者不适合化疗。从放疗到全层局部切除的间隔为6周。该协议要求在ypT2-3疾病或切缘阳性的情况下改行经腹手术。结果：9％的患者记录了需要住院的术后并发症。病理完全缓解率为41％。需要转换的患者比例为34％;但是，实际上有18％的人进行了转换，其余16％的人拒绝了或不适合。在中位随访的14个月中，有7％的患者发现了局部复发，所有患者均接受了挽救手术。在最初可能进行前切除术的19例患者中，有16％进行了腹部手术切除以进行转换或作为抢救方法。结论：我们的研究表明，局部切除之前的短程放射是高危患者的治疗选择。

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