演題抄録

ECCO/JSCO Joint Symposium

開催概要
開催回
第52回・2014年・横浜
 

Pros and cons of radiotherapy in rectal cancer treatment

演題番号 : ECJS-3

[筆頭演者]
van de Velde Cornelis:1 

1:Dept. of Surgical Oncology, Leiden University Medical Center, The Netherlands

 

The Dutch TME trial (n=1861) was initiated to investigate the effect of short-term preoperative radiotherapy in combination with TME surgery compared with TME surgery alone. This trial included 1861 patients. It was the first trial where surgical, pathological, and radiotherapeutical techniques were standardised and controlled for quality. The 10-year local recurrence rate was reduced by more than 50% for patients who received preoperative radiotherapy. Preoperative radiotherapy led to improved cancer-specific survival in patients with a negative resection margin. On the other hand, an increase in mortality due to other causes existed in patients who received preoperative radiotherapy, which resulted in an overall survival that did not differ between the two groups. For TNM stage III patients with a negative resection margin, preoperative short-term radiotherapy significantly improved 10-year survival.
Unfortunately, there are serious adverse events of preoperative radiotherapy: more sexual dysfunction, slower recovery of bowel function, impaired daily activity postoperatively, increased risk of anal and urinary dysfunction, and a possible increase in cardiovascular morbidity.
Patient selection for treatment is a balanced process of weighing the advantages and disadvantages of each modality. This patient-tailored approach demands the availability of information about CRM and lymph node involvement, biological tumour behaviour, and the expected response to treatment.

前へ戻る