Neoadjuvant radiotherapy in stage I cancer of the lower rectum

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• 作者：Jos&eacute ; Alfredo dos Reis Neto^a ; Jos&eacute ; Alfredo dos Reis Junior^b ; Odorino Hideyoshi Kagohara^b ; Joaquim Simõ ; es Neto^b ; Sergio Oliva Banci^b ; Luciane Hiane Oliveira^b ; Gustavo Alejandro Gutierrez Espinoza^a ; Antonio Jos&eacute ; Tiburcio Alves Jú ; nior^a ; ^{antonio_xxxv@yahoo.com.br" class="auth_mail" title="E-mail the corresponding author} ; ^{reisneto@lexxa.com.br" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Rectal neoplasms ; Radiotherapy ; Mortality ; Irradiation
• 刊名：Journal of Coloproctology
• 出版年：2016
• 出版时间：January-March 2016
• 年：2016
• 卷：36
• 期：1
• 页码：4-7
• 全文大小：646 K

文摘

The mortality rate in low rectal cancer is related to pelvic and distant recurrence. For stage I tumors, local excision has being used increasingly, but recent studies show the need for caution with the use of this technique, as they do not consider the possibility of a positive node in stage I rectal tumors. Therefore, preoperative radiotherapy should be considered for early tumors, as an attempt to prevent recurrence.

Objective

Show the effectiveness of neoadjuvant radiotherapy in stage I cancer of the lower rectum of a cohort population.

Material and method

A cohort study in a prospective database was made with a total of 538 patients, of which were considered 75 patients with stage I lower rectal cancer. Preoperative radiotherapy was performed and patients were followed up for a minimum period of five years.

Results

Stage I/TI group had 27 patients. All of them presented complete response to the treatment and did not need to be operated. During the follow up time of five years, this group showed no recurrence rate. The stage I/TII group had 48 patients. During the follow up, 8 patients had to be operated due to suspicious lesion or scar. They were submitted to full total local excision. After evaluating the pathological specimen, none of them proved to be adenocarcinoma.

Conclusion

Preoperative radiation, not only reduced the local recurrence and mortality rate in lower rectal cancer, but also reduced the need for surgery in patients with stage I cancer.