Current Treatment in Patients with Colorectal Cancer

Yıl 2018, Cilt: 10 Sayı: 1, 1 - 7, 01.03.2018

Gülhan Güler Avcı Özge Gümüşay

Öz

Abstract:

The primary treatment of rectal cancer is curative surgical resection, but surgery alone may be sufficient in patients with very early stage. Neoadjuvant radiotherapy, applied in local advanced rectal cancers, significantly reduces local recurrence. With the addition of radiotherapy and chemotherapy, pathological complete response and local control rates are increasing. More data is needed for the delay or timing of the surgeon.

Anahtar Kelimeler

Colorectal cancer, neoadjuvant radiotherapy, chemotherapy

Kolorektal Kanserlerde Güncel Tedavi Yaklaşımı

Öz

Rektum kanserinin temel tedavi yöntemi küratif cerrahi rezeksiyon olmakla birlikte, sadece çok erken evredeki hastalarda tek başına cerrahi yeterli olabilmektedir. Lokal ileri evre rektum kanserlerinde uygulanan neoadjuvan radyoterapi lokal yinelemeyi anlamlı olarak azaltmaktadır. Radyoterapiye, kemoterapi eklenmesi ile patolojik tam yanıt ve lokal kontrol oranları artmaktadır. Cerrahinin geciktirilmesi veya zamanlaması konusunda ise daha fazla veriye ihtiyaç bulunmaktadır.

Anahtar Kelimeler

Kolorektal kanser, neoadjuvan radyoterapi, kemoterapi

Kaynakça

• 1. Dahlberg M, Glimelius B, Påhlman L. Improved survival and reduction in local failure rates after preoperative radiotherapy: evidence for the generalizability of the results of Swedish Rectal Cancer Trial, AnnSurg. 1999;229(4):493-7.
• 2. Folkesson J, Birgisson H, Pahlman L, Cedermark B, Glimelius B, Gunnarsson U. Swedish Rectal Cancer Trial: long lasting benefits from radiotherapy on survival and local recurrence rate. J Clin Oncol. 2005;23(24):5644-50.
• 3. Kapiteijn E, Marijnen CA, Nagtegaal ID, Putter H, Steup WH, Wiggers T et al Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med. 2001;345(9):638-46.
• 4. Peeters KC, van de Velde CJ, Leer JW, Martijn H, Junggeburt JM, Kranenbarg EK, el al. Late side effects of short-course preoperative radiotherapy combined with total mesorectal excisionfor rectal cancer: increased bowel dysfunction in irradiated patients--a Dutch colorectal cancer group studyJ Clin Oncol. 2005;23(25):6199-206.
• 5. Roh MS, Colangelo L, Wieand S. Response to preoperative multimodality therapy predicts survival in patients with carcinoma of the rectum. In: 40th Annual Meeting of the American Society of Clinical Oncology, New Orleans, LA, J ClinOncol 2004:246.
• 6. Sauer R, Becker H, Hohenberger W, Rödel C, Wittekind C, Fietkau R, et al; German Rectal Cancer Study Group. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 2004;351:1731-40.
• 7. Roh MS, Colangelo LH, O'Connell MJ, Yothers G, Deutsch M, Allegra CJ, et al. Preoperative multimodality therapy improves disease-free survival in patients with carcinoma of the rectum: NSABP R-03. J Clin Oncol 2009;27:5124-30.
• 8. Gérard JP, Conroy T, Bonnetain F, Bouché O, Chapet O, Closon-Dejardin MT, et al. Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3-4 rectal cancers: results of FFCD 9203. J ClinOncol 2006;24:4620-5.
• 9. Bosset JF, Collette L, Calais G. EORTC Radiotherapy Group Trial 22921. Chemotherapy with preoperative radiotherapy in rectal cancer. N Engl J Med 2006;355:1114-23.
• 10. Bujko K, Nowacki MP, Nasierowska-Guttmejer A. Sphincter preservation following preoperative radiotherapy for rectal cancer: report of a randomized trial comparing short-term radiotherapy vs. conventionally fractionated radiochemotherapy. Radiother Oncol 2004;72:15-24.
• 11. Bujko K, Nowacki MP, Kepka L. Polish Colorectal Study Group. Postoperative complications in patients irradiated pre-operatively for rectal cancer: report of a randomized trial comparing short-term radiotherapy vs. chemoradiation. Colorectal Dis 2005;7:410-6.
• 12. Ngan S, Fisher R, Goldstein D. A randomized trial comparing local recurrence (LR) rates between short course (SC) and long course (LC) preoperative radiotherapy (RT) for clinical T3 rectal cancer: An intergroup trial (TROG, AGITG, CSSANZ, RACS). In: 46th Annual Meeting of the American Society of Clinical Oncology June 04-08, 2004, Chicago, IL, J ClinOncol2010:28.
• 13. Lefevre JH, Rousseau A, Svrcek M, Parc Y, Simon T, Tiret E; French Research Group of Rectal Cancer Surgery (GRECCAR) A multicentric randomized controlled trial on the impact of lengthening the interval between neoadjuvant radiochemo therapy and surgery on complete pathological response in rectal cancer (GRECCAR-6 trial): rationale and design. BMC Cancer. 2013;13:417.
• 14. Sloothaak DA, Geijsen DE, vanLeersum NJ, Punt CJ, Buskens CJ, Bemelman WA, et al. Optimal time interval between neoadjuvant chemoradio therapy and surgery for rectal cancer. Br J Surg. 2013;100(7):933-9.
• 15. Probst CP, Becerra AZ, Aquina CT, Tejani MA, Wexner SD, Garcia-Aguilar J, et al. Extended Intervals after Neoadjuvant Therapy in Locally Advanced Rectal Cancer: The Key to Improved Tumor Response and Potential Organ Preservation. J Am Coll Surg. 2015;221(2):430-40.