Distal intramural spread of rectal cancer after preoperative radiotherapy: The results of a multicenter randomized clinical study
Journal Article
·
· International Journal of Radiation Oncology, Biology and Physics
- Department of Pathology, Maria Sklodowska-Curie Memorial Cancer Center, Gliwice (Poland)
- Department of Radiotherapy, Maria Sklodowska-Curie Memorial Cancer Center, Warsaw (Poland)
- Department of Pathology, Maria Sklodowska-Curie Memorial Cancer Center, Warsaw (Poland)
- Department of Colorectal Cancer, Maria Sklodowska-Curie Memorial Cancer Center, Warsaw (Poland)
- Department of Pathology, Silesian Oncological Center, Wroclaw (Poland)
- Department of Pathology, Medical Academy, Poznan (Poland)
- Department of Pathology, Holy Cross Oncological Center, Kielce (Poland)
- Department of Pathology, Medical Academy, Gdansk (Poland)
- Department of Pathology, Medical Academy, Szczecin (Poland)
- Department of Pathology, Oncological Center, Bielsko-Biala (Poland)
Purpose: To evaluate the extent of distal intramural spread (DIS) after preoperative radiotherapy for rectal cancer. Methods and Materials: A total of 316 patients with T{sub 3-4} primary resectable rectal cancer were randomized to receive either preoperative 5x5 Gy radiation with immediate surgery or chemoradiation (50.4 Gy, 1.8 Gy per fraction plus boluses of 5-fluorouracil and leucovorin) with delayed surgery. The slides of the 106 patients who received short-course radiation and of the 86 who received chemoradiation were available for central microscopic evaluation of DIS. Results: The length of DIS did not differ significantly (p = 0.64) between the short-course group and the chemoradiation group and was 0 in 47% vs. 49%; 1 to 5 mm in 41% vs. 42%; 6 to 10 mm in 8% vs. 9%, and greater than 10 mm in 4% vs. 0, respectively. Among the 11 clinically complete responders, DIS was found 1 to 5 mm from the microscopically detected ulceration of the mucosa in 5 patients. The discontinuous DIS was more frequent in the chemoradiation group as compared with the short-course group (i.e., 57% vs. 16% of cases, p < 0.001). Conclusions: Approximately 1 out of 10 advanced rectal cancers after preoperative radiotherapy or radiochemotherapy was characterized by DIS of over 5 mm. No significant difference was seen in the length of DIS between the 2 groups.
- OSTI ID:
- 20793473
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 65; ISSN IOBPD3; ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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