Preoperative concurrent 5-Fluorouracil infusion, Mitomycin C and pelvic radiation therapy in tethered and fixed rectal carcinoma
- Tom Baker Cancer Centre, Calgary, Alberta (Canada)
This is a Phase 1/2 study of preoperative concurrent radiation and chemotherapy in tethered and fixed rectal carcinoma. This study examined the curative resectability, the acute toxicities during chemo-radiation and the surgical complications. Between 1986 and 1990, 46 patients were treated with preoperative pelvic radiation (4,000 cGy in 20 fractions in 4 weeks), 5-Fluorouracil infusion (20 mg/m[sup 2], days 1--4 and 15--18) and Mitomycin C (8 mg/m[sup 2], day 1). This was followed by surgery 6 to 8 weeks later. 30 patients had tethered tumors and 16 patients had fixed tumors. After preoperative chemo-radiation, 41 patients (89%) underwent curative resection. Two patients (4%) had no residual tumor found (T0N0M0). Seven patients (15%) had nodal metastases. Two patients developed grade 3 neutropenia (WBC = 1--2 [times] 10[sup 9]/L) during chemo-radiation. Five patients had delay in perineal wound healing. One patient had an anastomotic leak. Four patients developed stomal stenosis which required surgical revision. The 2-year actuarial survival was 73%. The 2-year local relapse rate was 16%. Patients with fixed carcinoma had a higher incidence of local failure (28% vs. 10%) and the difference was statistically significant (p = 0.0036). The 2-year distant failure rate was 41%, and the rates were similar for both tethered and fixed carcinomas. Preoperative pelvic radiation, chemotherapy and surgery could achieve a curative resection rate of 89% in tethered and fixed rectal carcinomas. However, distant metastases remained the major cause of failure. 42 refs., 6 figs., 4 tabs.
- OSTI ID:
- 6375697
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics; (United States), Vol. 25:5; ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
CARCINOMAS
CHEMOTHERAPY
RADIOTHERAPY
RECTUM
FLUOROURACILS
METASTASES
MITOMYCIN
POST-IRRADIATION EXAMINATION
SIDE EFFECTS
SURGERY
ANTI-INFECTIVE AGENTS
ANTIBIOTICS
ANTIMETABOLITES
ANTIMITOTIC DRUGS
ANTINEOPLASTIC DRUGS
AZINES
BODY
DIGESTIVE SYSTEM
DISEASES
DRUGS
GASTROINTESTINAL TRACT
HETEROCYCLIC COMPOUNDS
HYDROXY COMPOUNDS
INTESTINES
LARGE INTESTINE
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANIC FLUORINE COMPOUNDS
ORGANIC HALOGEN COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PYRIMIDINES
RADIOLOGY
THERAPY
URACILS
550603* - Medicine- External Radiation in Therapy- (1980-)