Preview

Grekov's Bulletin of Surgery

Advanced search

Neoadjuvant chemoradiotherapy in combined treatment of patients with rectal cancer

https://doi.org/10.24884/0042-4625-2017-176-4-31-38

Abstract

OBJECTIVE. The article analyzed an efficacy and safety of application of neoadjuvant chemoradiotherapy (CRT) in elderly and senile patients with rectal cancer. MATERIAL AND METHODS. An analysis of treatment results was made in 267 patients, who were divided into two groups. The first group (n = 142) underwent combined treatment that included prolonged course of neoadjuvant CRT followed by surgery. The second group of 125 patients underwent surgery without application of CRT. The patients of both groups were subdivided according their age. The subgroup “A” consisted of young and middle age patients. The subgroup “B” included geriatric patients. Comparative analysis was made between the same age subgroups. RESULTS. The age factor didn’t significantly influence on the risk of complications of neoadjuvant CRT and its adverse effects on subsequent outcome of surgery. The application of preoperative CRT in geriatric patients accompanied by less significant growth of recurrence-free survival compared with young patients. CONCLUSIONS. The age factor shouldn’t restrict the application of neoadjuvant CRT in patients with satisfactory general health status and absence of tumor complication process.

About the Authors

N. A. Maistrenko
S. M. Kirov Military Medical Academy
Russian Federation


V. N. Galkin
National Medical Research Radiological Centre
Russian Federation


D. V. Erygin
National Medical Research Radiological Centre
Russian Federation


A. A. Sazonov
S. M. Kirov Military Medical Academy
Russian Federation


References

1. Гордеев С. С., Расулов А. О., Барсуков Ю. А. и др. Возможно ли сужение показаний к предоперационной лучевой терапии у больных раком прямой кишки? // Колопроктология. 2014. Т. 48, № 2. С. 39-47.

2. Ерыгин Д. В., Бердов Б. А., Невольских А. А. Неоадъювантная химиолучевая терапия местнораспространенного рака прямой кишки // Онкология. 2015. № 1. С. 13-20.

3. Каприн А. Д.,Старинский В. В.,Петрова Г. В.Злокачественные новообразования в России в 2014 г. (заболеваемость и смертность). M.: МНИОИ им. П. А. Герцена, 2016. 250 с.

4. Черданцев Д. В., Поздняков А. А., Шпак В. В. и др. Несостоятельность колоректального анастомоза. Современное состояние проблемы (обзор литературы) // Колопроктология. 2015. № 4. С. 57-62.

5. Audisio R. A., Papamichael D. Treatment of colorectal cancer in older patients // Nat. Rev. Gastroenterol. Hepatol. 2012. Vol. 9, № 12. P. 716-725.

6. Ciara R., Boselli D., Hill J. S., Salo J. C. Optimal timing of surgical resection after radiation therapy in locally advanced rectal adenocarcinoma: an analysis of the National Cancer Database (NCDB) // J. Clin. Oncol. 2015. Vol. 33. P. 510.

7. Folkesson J., Birgisson F. I., Pahlman L. et al. Swedish Rectal Cancer Trial. Long lasting benefits from radiotherapy on survival and local recurrence rate // J. Clin. Oncol. 2005. Vol. 23, № 24. P. 5644-5650.

8. Goi T., Kawasaki M., Inoue T. et al. Clinicopathological analysis of colorectal cancers in the elderly // Intern. Surg. 2009. Vol. 94, № 3. P. 189-195.

9. Larsen S. G., Wiig J. N., Tretli S. et al. Surgery and preoperative irradiation for locally advanced or reccurent rectal cancer in patients over 75 years of age // Colorectal Dis. 2006. Vol. 8, № 3. P. 177-185.

10. Papamichael D, Audisio R.A, Glimelius B. et al. Treatment of colorectal cancer in older patients. International Society of Geriatric Oncology (SIOG) consensus recommendations 2013 // Ann. Oncol. 2015. Vol. 26, № 3. P. 463-476.

11. Pedrazzani C., Cerullo G., De Marco G. et al. Impact of age-related comorbidity on results of colorectal cancer surgery // World J. Gastroenterol. 2009. Vol. 15, № 45. P. 5706-5711.

12. Van Gijn W., Marijnen C. A., Nagtegaal I. D. et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomized TME trial // Lancet Oncol. 2011. Vol. 12, № 6. P. 575-582.


Review

For citations:


Maistrenko N.A., Galkin V.N., Erygin D.V., Sazonov A.A. Neoadjuvant chemoradiotherapy in combined treatment of patients with rectal cancer. Grekov's Bulletin of Surgery. 2017;176(4):31-38. (In Russ.) https://doi.org/10.24884/0042-4625-2017-176-4-31-38

Views: 447


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 0042-4625 (Print)
ISSN 2686-7370 (Online)