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Title: Preoperative chemoradiation of locally advanced T3 rectal cancer combined with an endorectal boost

Abstract

Purpose: To investigate the effect and feasibility of concurrent radiation and chemotherapy combined with endorectal brachytherapy in T3 rectal cancer with complete pathologic remission as end point. Methods and Materials: The study included 50 patients with rectal adenocarcinoma. All patients had T3 tumor with a circumferential margin 0-5 mm on a magnetic resonance imaging scan. The radiotherapy was delivered by a technique including two planning target volumes. Clinical target volume 1 (CTV1) received 60 Gy/30 fractions, and CTV2 received 48.6 Gy/27 fractions. The tumor dose was raised to 65 Gy with endorectal brachytherapy 5 Gy/1 fraction to the tumor bed. On treatment days, the patients received uracil and tegafur 300 mg/m2 concurrently with radiotherapy. Results: Forty-eight patients underwent operation. Histopathologic tumor regression was assessed by the Tumor Regression Grade (TRG) system. TRG1 was recorded in 27% of the patients, and a further 27% were classified as TRG2. TRG3 was found in 40%, and 6% had TRG4. The toxicity was low. Conclusion: The results indicate that high-dose radiation with concurrent chemotherapy and endorectal brachytherapy is feasible with a high rate of complete response, but further trials are needed to define its possible role as treatment option.

Authors:
 [1];  [2];  [2];  [2];  [2];  [2]
  1. Danish Colorectal Cancer Group South, University of Southern Denmark, Vejle Hospital, Vejle (Denmark). E-mail: andjac@vgs.vejleamt.dk
  2. Danish Colorectal Cancer Group South, University of Southern Denmark, Vejle Hospital, Vejle (Denmark)
Publication Date:
OSTI Identifier:
20793305
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 64; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2005.07.969; PII: S0360-3016(05)02227-3; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRACHYTHERAPY; CARCINOMAS; CHEMOTHERAPY; NMR IMAGING; PATIENTS; RADIATION DOSES; TOXICITY; URACILS

Citation Formats

Jakobsen, Anders, Mortensen, John P., Bisgaard, Claus, Lindebjerg, Jan, Hansen, Johnny W., and Rafaelsen, Soren R.. Preoperative chemoradiation of locally advanced T3 rectal cancer combined with an endorectal boost. United States: N. p., 2006. Web. doi:10.1016/J.IJROBP.2005.0.
Jakobsen, Anders, Mortensen, John P., Bisgaard, Claus, Lindebjerg, Jan, Hansen, Johnny W., & Rafaelsen, Soren R.. Preoperative chemoradiation of locally advanced T3 rectal cancer combined with an endorectal boost. United States. doi:10.1016/J.IJROBP.2005.0.
Jakobsen, Anders, Mortensen, John P., Bisgaard, Claus, Lindebjerg, Jan, Hansen, Johnny W., and Rafaelsen, Soren R.. Wed . "Preoperative chemoradiation of locally advanced T3 rectal cancer combined with an endorectal boost". United States. doi:10.1016/J.IJROBP.2005.0.
@article{osti_20793305,
title = {Preoperative chemoradiation of locally advanced T3 rectal cancer combined with an endorectal boost},
author = {Jakobsen, Anders and Mortensen, John P. and Bisgaard, Claus and Lindebjerg, Jan and Hansen, Johnny W. and Rafaelsen, Soren R.},
abstractNote = {Purpose: To investigate the effect and feasibility of concurrent radiation and chemotherapy combined with endorectal brachytherapy in T3 rectal cancer with complete pathologic remission as end point. Methods and Materials: The study included 50 patients with rectal adenocarcinoma. All patients had T3 tumor with a circumferential margin 0-5 mm on a magnetic resonance imaging scan. The radiotherapy was delivered by a technique including two planning target volumes. Clinical target volume 1 (CTV1) received 60 Gy/30 fractions, and CTV2 received 48.6 Gy/27 fractions. The tumor dose was raised to 65 Gy with endorectal brachytherapy 5 Gy/1 fraction to the tumor bed. On treatment days, the patients received uracil and tegafur 300 mg/m2 concurrently with radiotherapy. Results: Forty-eight patients underwent operation. Histopathologic tumor regression was assessed by the Tumor Regression Grade (TRG) system. TRG1 was recorded in 27% of the patients, and a further 27% were classified as TRG2. TRG3 was found in 40%, and 6% had TRG4. The toxicity was low. Conclusion: The results indicate that high-dose radiation with concurrent chemotherapy and endorectal brachytherapy is feasible with a high rate of complete response, but further trials are needed to define its possible role as treatment option.},
doi = {10.1016/J.IJROBP.2005.0},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 64,
place = {United States},
year = {Wed Feb 01 00:00:00 EST 2006},
month = {Wed Feb 01 00:00:00 EST 2006}
}