Adjuvant Therapy in Rectal Cancer

Česká verzia

Authors: P. Lovas; Z. Lovasová
Authors place of work: Klinika radiační onkologie LF MU, Masarykův onkologický ústav, Brno
Published in the journal: Klin Onkol 2011; 24(2): 94-100
Category: Reviews

Summary

Backgrounds:
Rectal cancer treatment has noticed several important changes in last years. TME, new radiotherapy techniques and new systemic agents have been introduced. Preoperative staging has improved. Nevertheless the neoadjuvant treatment approach is not unified all over the world.

Material and Methods:
Using the following American and European guidelines we found primary citations and compared their results.

Conclusion:
Currently, there are substantial differences in neoadjuvant dose of radiotherapy between European and American guidelines. Short neoadjuvant course of radiotherapy seems to be appropriate in patients with smaller primary operable rectal cancer. This approach is safe if chosen, not oppressing stage III patients by protracted oncological treatment including chemotherapy.

Key words:
rectal cancer – adjuvant radiotherapy – neoadjuvant radiotherapy – adjuvant chemotherapy – neoadjuvant chemotherapy – total mesorectal excision

Zdroje

1. Český národní webový portál epidemiologie nádorů. Masarykova univerzita, Česká republika. 2005. http://www.svod.cz.

2. Mohammed M, Czito BG et al. Rectal cancer. In: Halperin CH, Perez CA, Brady LW et al (eds). Principles and practice of radiation oncology. 5th ed. Philadelphia: Lippincot Williams § Wilkins 2004: 1366–1367.

3. Gunderson LL, O’Connell MJ. The postoperative chemotherapy/irradiation adjuvant strategy. In: Cohen AF, Winawer SJ, Friedman MA et al (eds). Cancer of the colon, rectum, and anus. New York: McGraw-Hil 1995: 631–645.

4. Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery the cene to pelvic recurens? Br J Surg 1982; 69(10): 613–616.

5. MacFarlane JK, Ryall RD, Heald RJ. Mesorectal excision for rectal cancer. Lancet 1993; 341(8843): 457–460.

6. Gunderson LL, Sosin H. Areas of failure found at reoperation (second or symptomatic look) following “curative surgery” for adenocarcinoma of the rectum. Clinicopathologic correlation and implications for adjuvant therapy. Cancer 1974; 34(4): 1278–1292.

7. Glimelius B, Påhlman L, Cervantes A. Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annl Oncol 2010; 21 (Suppl 5): v82–v86.

8. National Comprehensive Cancer Network, NCCN Clinical Practice Guidelines in Oncology: Rectal cancer V. 2010, USA. http://www.nccn.com.

9. Zagras GK. Principles of combining radiation therapy and surgery. In: Cox JD, Ang KK (eds). Radiation oncology rationale technique, results. 8th ed. St. Louis: Mosby 2003: 97–107.

10. Holland R, Veling SH, Mravunac M et al. Histologic multifocality of Tis, T1–2 breast carcinomas. Implications for clinical trials of breast-conserving surgery. Cancer 1985; 56(5): 979–990.

11. Gerard JP, Romestaing P, Ardiet JM et al. Sphincter preservation in rectal cancer. Endocavitary radiation therapy. Sem Radiat Oncol 1998; 8(1): 13–23.

12. Coatmeur O, Truc G, Barillot I et al. Treatment of T1–T2 rectal tumors by contact therapy and interstitial brachytherapy. Radiother Oncol 2004; 70(2): 177–182.

13. Smalley SR, Benedetti JK, Williamson SK et al. Phase III trial of fluorouracil-based chemotherapy regimens plus radiotherapy in postoperative adjuvant rectal cancer: GI INT 0144. J Clin Oncol 2006; 24(22): 3542–3547.

14. Fisher B, Wolmark N, Rockette H et al. Adjuvant chemotherapy or post-operative radiation for rectal cancer: 5 year results of NSABP protocol R-01. Am Soc Clin Oncol 1987; 6(A): 359–392.

15. Krook JE, Moertel CG, Gunderson LL. Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med 1991; 324(11): 709–715.

16. Roh MS, Colangelo LH, O’Connell MJ et al. Preoperative multimodality therapy improves disease-free survival in patients with carcinoma of the rectum: NSABP R-03. J Clin Oncol 2009; 27(31): 5124–5130.

17. Sebag-Montefiore D, Stephens RJ, Steele R et al. Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial. Lancet 2009; 373(9666): 811–820.

18. Sauer R, Fietkau R, Wittekind C et al. Adjuvant versus neoadjuvant radiochemotherapy for locally advanced rectal cancer. A progress report of a phase-III randomized trial (protocol CAO/ARO/AIO-94). Strahlenther Onkol 2001; 177(4): 173–181.

19. Gerard JP, Chapet O, Nemoz C et al. Improved sphincter preservation in low rectal cancer with high-dose preoperative radiotherapy: the Lyon R96-02 randomized trial. J Clin Oncol 2004; 22(12): 2404–2409.

20. Glimelius B, Grönberg H, Järhult J et al. A systematic overview of radiation therapy effects in rectal cancer. Acta Oncol 2003; 42(5–6): 476–492.

21. Rödel C, Hohenberger W, Sauer R. Adjuvant and neoadjuvant therapy of rectal carcinoma. The current status. Strahlenther Onkol 1998; 174(10): 497–504.

22. Valentini V, Beets-Tan R, Borras JM et al. Evidence and research in rectal cancer. Radiother Oncol 2008; 87(3): 449–474.

23. Gérard JP, Conroy T, Bonnetain F et al. Preoperative radiotherapy with or without concurrent Fluorouracil and leucovorin in T3-4 rectal cancers: results of FFCD 9203. J Clin Oncol 2006; 24(28): 4620–4625.

24. Collette L, Bosset JF, den Dulk M et al. Patients with curative resection of cT3-4 rectal cancer after preoperative radiotherapy or radiochemotherapy: does anybody benefit from adjuvant fluorouracil-based chemotherapy? A trial of the European Organisation for Research and Treatment of Cancer Radiation Oncology Group. J Clin Oncol 2007; 25(28): 4379–4386.

25. Kim JS, Cho MJ, Song KS et al. Preoperative chemoradiation using oral capecitabine in locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 2002; 54(2): 403–408.

26. Schmoll HJ, Cartwright T, Tabernero J et al. Phase III trial of capecitabine plus oxaliplatin as adjuvant therapy for stage III colon cancer: a planned safety analysis in 1,864 patients. J Clin Oncol 2007; 25(1): 102–109.

27. Gunderson LL, Sosin H. Areas of failure at reoperation (second or symptomatic look) following “curative surgery” for adenocarcinoma of the rectum. Clinicopathologic correlation and implications for adjuvant therapy. Cancer 1974; 34(4): 1278–1292.

28. Roels S, Duthoy W, Haustermans K et al. Definition and delineation of the clinical target volume for rectal cancer. Int J Radiat Oncol Biol Phys 2006; 65(4): 1129–1142.

29. Bagatzounis A, Kölbl O, Müller G et al. The locoregional recurrence of rectal carcinoma. A computed tomographic analysis and a target volume concept for adjuvant radiotherapy. Strahlenther Onkol 1997; 173(2): 68–75.

30. Bujko K, Nowacki MP, Nasierowska-Guttmejer A et al. Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer. Br J Surg 2006; 93(10): 1215–1223.

31. Gunderson LL, Sergent DJ, Tepper JE et al. Impact of T and N stage and treatment on survival and relapse in adjuvant rectal cancer: a pooled analysis. J Clin Oncol 2004; 22(10): 1785–1796.

32. MERCURY Study Group. Extramural depth of tumor invasion at thin-section MR in patients with rectal cancer: results of the MERCURY study. Radiology 2007; 2431): 132–139.

33. Bujko K, Kolodziejczyk M. The 5 × 5 Gy with delayed surgery in non-resectable rectal cancer: a new treatment option. Radiother Oncol 2008; 87(3): 311–313.

34. Doleželová H, Ondrová B, Hynková L. Moderní radioterapie v léčbě kolorektálního karcinomu. In: Vyzula R, Žaloudík J et al (eds). Rakovina tlustého střeva a konečníku: vybrané kapitoly. Praha: Maxdorf 2007: 205–217.

35. Šlampa P, Kocáková I, Šefr R et al. Neoadjuvant treatment for locally advanced rectal adenocarcinoma with concomitant radiotherapy and oral capecitabine. J BUON 2004; 9(1): 33–40.

36. Šlampa P, Tomášek J. Radioterapie nádorů konečníku. Referátový výběr z onkologie 2008; 25(1+2): 32–36.