Phase I/II trial of pre-operative radiation therapy and coloanal anastomosis in distal invasive resectable rectal cancer Journal Article
| Authors: | Minsky, B. D.; Cohen, A. M.; Enker, W. E.; Sigurdson, E. |
| Article Title: | Phase I/II trial of pre-operative radiation therapy and coloanal anastomosis in distal invasive resectable rectal cancer |
| Abstract: | A total of 22 patients with the diagnosis of invasive, resectable, primary adenocarcinoma of the rectum limited to the pelvis were enrolled on a Phase I/II trial of pre-operative radiation therapy + low anterior resection/coloanal anastomosis. By pre-operative assessment, all patients had invasive tumors involving the distal half of the rectum and required an abdominoperineal resection. The median tumor size was 4 cm (1.5-6 cm) and the median distance from the anal verge was 4 cm (3-7 cm). The whole pelvis received 4680 cGy followed by a 360 cGy boost to the primary tumor bed. The median follow-up was 29 months (10-60 months). Of the 21 patients who underwent resection, 10% had a complete pathologic response and 90% were able to successfully undergo a low anterior resection/coloanal anastomosis. The incidence of local failure as a component of failure was crude: 23% and 4-year actuarial: 32%. The 4-year actuarial survival was 61%. No patients experienced Grade 3 or 4 toxicity while receiving radiation therapy, and 6% developed a partial disruption of the anastomosis. Of the patients who underwent a low anterior resection/coloanal anastomosis, 89% had a good or excellent functional result. This technique may be an alternative to an abdominoperineal resection in selected patients. Further follow-up is needed in order to determine if this approach ultimately has similar local control and survival rates as an abdominoperineal resection. © 1992. |
| Keywords: | adult; cancer survival; clinical article; aged; survival rate; cancer radiotherapy; combined modality therapy; cancer staging; follow up; follow-up studies; pelvis; preoperative evaluation; adenocarcinoma; tumor volume; radiation injury; gastrointestinal toxicity; organ preservation; radiation beam; cancer control; rectal neoplasms; rectum cancer; radiotherapy, high-energy; colon; rectal cancer; rectum anterior resection; rectum abdominoperineal resection; anus sphincter; middle age; intestine anastomosis; preoperative radiotherapy; anus; human; male; female; priority journal; article; support, non-u.s. gov't; pre-operative radiation therapy |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 23 |
| Issue: | 2 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 1992-01-01 |
| Start Page: | 387 |
| End Page: | 392 |
| Language: | English |
| DOI: | 10.1016/0360-3016(92)90757-9 |
| PUBMED: | 1587760 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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