Dergiler / Turkish Journal of Medical Sciences / 2019 / Cilt: 49 - Sayı: 5

Neoadjuvant volumetric modulated arc radiochemotherapy with a simultaneous integrated boost technique compared to standard chemoradiation for locally advanced rectal cancer

Sayfa
1484–1489
Yayın Tarihi
2022-11-04
DOI
—
🏛️Bu makalenin bibliyografik verileri ve tam metin bağlantısı DergiPark üzerinden sağlanmıştır.
DergiPark Kaydı ↗
✨

Yapay Zeka Hızlı Bakış & Çıkarımlar

AI Insight
⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Its effectiveness is expressed inhigher clinical and pathological complete response rates and safety with the same rates of acute toxicity.

📌 3 Maddede Bu Makale

🎯
Amaç & Hipotez:Background/aim: The present study aimed to examine whether the combination of neoadjuvant volumetric modulated arc radiotherapy(VMAT) using simultaneous integrated boost (SIB-VMAT) techniques and chemotherapy with capecitabine is associated with better clinicaland dosimetric outcomes compared to the standard treatment.Materials and methods: The study included 59 patients with cT2–T4 rectal cancer.
📊
Temel Bulgular & Veri:In the standard arm, patients (n = 37) were treatedpreoperatively with image-guided VMAT plus capecitabine.
💡
Sonuç & Katkı:Its effectiveness is expressed inhigher clinical and pathological complete response rates and safety with the same rates of acute toxicity.
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Abstract

Background/aim: The present study aimed to examine whether the combination of neoadjuvant volumetric modulated arc radiotherapy(VMAT) using simultaneous integrated boost (SIB-VMAT) techniques and chemotherapy with capecitabine is associated with better clinicaland dosimetric outcomes compared to the standard treatment.Materials and methods: The study included 59 patients with cT2–T4 rectal cancer. In the standard arm, patients (n = 37) were treatedpreoperatively with image-guided VMAT plus capecitabine. In the SIB arm, patients (n = 22) were treated with the SIB-VMAT techniqueplus capecitabine. All patients underwent radical surgical resection after neoadjuvant radiochemotherapy.Results: In the standard arm, cT0N0 was reached in 12 patients (32.4%), primary tumor clinical downstaging was observed in 22 patients(59.5%), and disease stability was achieved in 3 patients (8.1%). In the SIB arm, cT0N0 was reached in 15 patients (68.2%), primary tumorclinical downstaging was observed in 6 patients (27.3%), and disease stability was achieved in 1 patient (4.5%) (P = 0.028). Completepathological response was observed in 11 patients (29.7%) in the standard arm and in 13 patients (59.1%) in the SIB arm (P = 0.026). In theSIB arm mild diarrhea appeared in 59.1%, moderate in 40.9%, and severe in 0% of the cases. In the standard arm mild, moderate, and severediarrhea rates were in 54.1%, 43.2%, and 2.7%, respectively. In the SIB arm mild, moderate, and severe cystitis appeared in 63.6%, 22.7%,and 13.6%, while in the standard group mild cystitis developed in 67.6%, moderate in 24.3%, and severe in 8.1%. Mild, moderate, and severeradiation dermatitis rates were 45.5%, 45.5%, and 9.1% in the SIB group and 40.5%, 48.6%, and 10.8% in the standard group, respectively.Conclusion: The SIB-VMAT technique is effective and safe for irradiating locally advanced rectal cancer. Its effectiveness is expressed inhigher clinical and pathological complete response rates and safety with the same rates of acute toxicity.

🔖

Bu Makaleye Atıf Yap

JANKARASHVILI, N., TURKIASHVILI, L., KAKHADZE, S., TOPESHASHVIL, M., TCHIABRISHVILI, M. (2022). Neoadjuvant volumetric modulated arc radiochemotherapy with a simultaneous integrated boost technique compared to standard chemoradiation for locally advanced rectal cancer. Turkish Journal of Medical Sciences, Cilt: 49 - Sayı: 5, 1484–1489. https://ajindex.com/articles/610262

📄 Tam Metin PDF Okuyucu

📄

PDF görüntüleyici hazırlanıyor...

Kaynakça (11)

  1. Trakarnsanga A, Ithimakin S, Weiser MR. Treatment of locally advanced rectal cancer: controversies and questions. World Journal of Gastroenterology 2012
  2. 18 (39): 5521-5532. doi: 10.3748/wjg.v18.i39.5521 2. de Wilt JHW, Vermaas M, Ferenschild FTJ, Verhoef C. Management of locally advanced primary and recurrent rectal cancer. Clinics in Colon and Rectal Surgery 2007
  3. 20 (3): 255- 264. doi: 10.1055/s-2007-984870 3. Sauer R, Becker H, Hohenberger W, Rödel C, Wittekind C et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. New England Journal of Medicine 2004
  4. 351 (17): 1731-1740. doi: 10.1056/NEJMoa040694 4. Glynne-Jones R, Harrison M. Locally advanced rectal cancer: what is the evidence for induction chemoradiation? Oncologist 2007
  5. 12 (11): 1309-1318. doi: 10.1634/ theoncologist.12-11-1309 5. Voelter V, Zouhair A, Vuilleumier H, Matter M, Bouzourene H et al. CPT-11 and concomitant hyperfractionated accelerated radiotherapy induce efficient local control in rectal cancer patients: results from a phase II. British Journal of Cancer 2006
  6. 95 (6): 710-716. doi: 10.1038/sj.bjc.6603322 6. Krishnan S, Janjan NA, Skibber JM, Rodriguez-Bigas MA, Wolff RA et al. Phase II study of capecitabine (Xeloda) and concomitant boost radiotherapy in patients with locally advanced rectal cancer. International Journal of Radiation Oncology, Biology, Physics 2006
  7. 66 (3): 762-771. doi: 10.1016/j. ijrobp.2006.05.063 7. Mok H, Crane CH, Palmer MB, Briere TM, Beddar S et al. Intensity modulated radiation therapy (IMRT): differences in target volumes and improvement in clinically relevant doses to small bowel in rectal carcinoma. Radiation Oncology 2011
  8. doi: 10.1186/1748-717X-6-63 8. Richetti A, Fogliata A, Clivio A, Nicolini G, Pesce G et al. Neoadjuvant chemo-radiation of rectal cancer with volumetric modulated arc therapy: summary of technical and dosimetric features and early clinical experience. Radiation Oncology 2010
  9. doi: 10.1186/1748-717X-5-14 9. Cilla S, Caravatta L, Picardi V, Sabatino D, Macchia G et al. Volumetric modulated arc therapy with simultaneous integrated boost for locally advanced rectal cancer. Clinical Oncology 2012
  10. 24 (4): 261-268. doi: 10.1016/j.clon.2011.07.001 10. Ahnesjo A, Hardemark B, Isacsson U, Montelius A. The IMRT information process e mastering the degrees of freedom in external beam therapy. Physics in Medicine and Biology 2006
  11. 51 (13): 381-402. doi: 10.1088/0031-9155/51/13/R22 11. Movsas B, Diratzouian