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Titolo:
Influence of the interval between preoperative radiation therapy and surgery on downstaging and on the rate of sphincter-sparing surgery for rectal cancer: The Lyon R90-01 randomized trial
Autore:
Francois, Y; Nemoz, CJ; Baulieux, J; Vignal, J; Grandjean, JP; Partensky, C; Souquet, JC; Adeleine, P; Gerard, JP;
Indirizzi:
CHU Lyon Sud, Hospices Civils Lyon, Dept Surg, F-69495 Pierre Benite, France CHU Lyon Sud Pierre Benite France F-69495 F-69495 Pierre Benite, France CHU Lyon Sud, Dept Radiat Oncol, F-69495 Pierre Benite, France CHU Lyon Sud Pierre Benite France F-69495 F-69495 Pierre Benite, France Hop Croix Rousse, Dept Surg, F-69317 Lyon, France Hop Croix Rousse Lyon France F-69317 se, Dept Surg, F-69317 Lyon, France Hop Croix Rousse, Dept Gastroenterol, F-69317 Lyon, France Hop Croix Rousse Lyon France F-69317 Gastroenterol, F-69317 Lyon, France Hospices Civils Lyon EA643, Med Stat Lab, Lyon, France Hospices Civils Lyon EA643 Lyon France A643, Med Stat Lab, Lyon, France Clin St Marie Therese, Dept Surg, Bron, France Clin St Marie Therese Bron France arie Therese, Dept Surg, Bron, France Hop Edouard Herriot, Dept Surg, Lyon, France Hop Edouard Herriot Lyon France douard Herriot, Dept Surg, Lyon, France
Titolo Testata:
JOURNAL OF CLINICAL ONCOLOGY
fascicolo: 8, volume: 17, anno: 1999,
pagine: 2396 - 2402
SICI:
0732-183X(199908)17:8<2396:IOTIBP>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
COLOANAL ANASTOMOSIS; ANTERIOR RESECTION; ADJUVANT TREATMENT; MULTICENTER TRIAL; CURATIVE SURGERY; RADIOTHERAPY; CARCINOMA; ADENOCARCINOMA; RT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
37
Recensione:
Indirizzi per estratti:
Indirizzo: Gerard, JP CHU Lyon Sud, Hospices Civils Lyon, Dept Surg, 165 Chemin GrandRevoyet, F-69495 Pierre Benite, France CHU Lyon Sud 165 Chemin Grand Revoyet Pierre Benite France F-69495
Citazione:
Y. Francois et al., "Influence of the interval between preoperative radiation therapy and surgery on downstaging and on the rate of sphincter-sparing surgery for rectal cancer: The Lyon R90-01 randomized trial", J CL ONCOL, 17(8), 1999, pp. 2396-2402

Abstract

Purpose: The optimal timing of surgery after preoperative radiotherapy in rectal cancer is unknown. The aim of this trial was to evaluate the role ofthe interval between preoperative radiotherapy and surgery. Patients and Methods: patients with rectal carcinoma accessible to rectal digital examination, staged T2 to T3, NX, M0, were randomized before radiotherapy (39 Gy in 13 fractions) into two groups: in the short interval (SI) group, surgery herd ta be performed within 2 weeks after completion of radiation therapy compared with 6 to 8 weeks in the long interval (LI) group. Between 1991 and 1995, 201 patients were enrolled onto the study. Results: A long interval between preoperative radiotherapy and surgery wasassociated with a significantly better clinical tumor response (53.1% in the SI group v 71.7% in the LI group, P = .007) and pathologic downstaging (10.3% in the SI group v 26% in the LI group, P = .005), At a median follow-up of 33 months, there were no differences in morbidity, local relapse, andshort-term survival between the two groups. Sphincter-preserving surgery was performed in 76% of cases in the LI group versus 68% in the SI group (P = 0.27). Conclusion: A long interval between preoperative irradiation and surgery provides increased tumor downstaging with no detrimental effect on toxicity and early clinical results. When sphincter preservation is questionable, a long interval may increase the chance of a successful sphincter-saving surgery. (C) 1999 by American Society of Clinical Oncology.

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Documento generato il 26/09/20 alle ore 03:51:23