Rektum Kanserli Hastalarımızın Epidemiyolojik Demografik Özelliklerinin ve Tedavi Yaklaşımlarının Değerlendirilmesi

Yıl 2008, Cilt: 41 Sayı: 1, 41 - 44, 01.04.2008

Taciser Demirkasımoğlu V. İşıl Uğur Yeşim Elgin Bülent Küçükplakçı Aytül Özgen Cem Mısırlıoğlu Ergun Sanrı Pınar Kara Handan Erkal Nadi Özdamar

Öz

Two-hundred-eighty patients with rectum cancer treated in Radiation Oncology Department of Ankara Oncology Hospital bet-ween January 2000-December 2004 revievved retrospectively. Median age of the patients were 59. Men/women ratio was 1.2/1. Adenocarcinoma was the majör celi type. Tumour of the 56 patients were grade 1, 83 patients were grade 2 and 7 patients were grade 3. Most of the patients seen in our department were stage IIA. Incidence of rectum carcinoma was high in the middle third of rectum. Two-hundred-thirty-five patients were operable, 45 were inoperable. One-hundred-seven patients had APR (abdomi-noperineal resection), 107 had LAR (low anterior resection), 7 had resection as a surgical procedure. One-hundred-eighty patients had chemotherapy before radiotherapy. Two-hundred-thirty-five patients had postoperative radiotherapy, 14 had preopera-tive and 31 patients had palliative radiotherapy. One-hundred-sixty-nine patients had chemoradiotherapy.

Anahtar Kelimeler

Rectum cancer, radiotherapy.

Epidemyologic Results of the Patierıts with Rectal Cancer

Öz

Ankara Onkoloji Hastanesi Radyasyon Onkolojisi Kliniğine 1 Ocak 2000-31 Aralık 2004 tarihleri arasında başvuran rektum kanserli 280 hasta retrospektif olarak değerlendirildi. Hastalar; genel özellikleri açısından incelendi. Hastaların medyan yaşı 59, erkek/kadın oranı 1.2/1 bulundu. En sık rastlanan tümör histopatolojisi adenokarsinom idi. Hastaların 56'sı gradel, 83'ü grade 2, 7'si grade 3 olarak bulundu. Kliniğimize en çok Evre HA hastaların başvurduğu saptandı. Tümör, en fazla rektum orta yerleşimli idi. Hastaların 235'i öpere, 45'i inopere idi. İki yüz yirmi bir hastanın 107'sine abdomino-perineal rezeksiyon, 107'sine low anterior rezeksiyon, 7'sine sadece rezeksiyon yapılmıştı. Yüzseksen hastaya radyoterapi öncesi kemoterapi uygulanmıştı, ikiyüzseksen hastanın 235'ipostoperatif, 14'üpreoperatif, 31 'ipalyatif amaçlı ışınlanmıştı. Hastaların 169'una radyoterapi ile eşzamanlı kemoterapi verilmişti.

Anahtar Kelimeler

Rektum kanseri, radyoterapi.

Kaynakça

• Landis SH, Murray T, Bolden S, et al. Cancer statistics 1998. CA Cancer J d in 1998;48:6-29.
• Almagro UA. Primary signet-ring carcinoma of the colon. Cancer 1983;52:1453-7.
• Myerson RJ, Michalski JM, King ML, et al. Adjuvant radiati
• on therapy for rectal carcinoma:Predictors o f outcome. Int J Radiat Oncol Biol Phys 1995;32:41-50.
• Perez C et al. Principles and Practice o f Radiation. Oncology 1998,1607-29.
• Kodner IJ. İn: Zinner MJ, Schvvartz SI, Ellis H, (eds). Rectal
• cancer in Maingots abdominal operations. Stamford, CT: Appleton and Lange, 1997:1455-502.
• Mohiuddin M, Marks G, Bannon J. High dose preoperative
• radiation and full thickness local excision: A new option for selected T3 distal rectal cancers. Int J Radiat Oncol Biol Phys 1994;30:845-9.
• 1Mlliams NS, Dixon MF, Johrıston D. Reappraisal o f the 5 centimetre rule o f distal excision for carcinoma of the rec- tum: A study o f distal intramural spread and of patients sur- vival.BrJ Surg 1983;70:150-4.
• De Gramont A, Bosset JF, Milan C, et al. Randomized trial
• comparing monthly iow-dose leucovorin and fluorouracil bolus with bimonthly for advanced colorectal cancer: A French Intergroup Study. J Clin Oncol 1997;15:808-15.
• FisherB, Wolmark N, Rockette H, et al. Postoperative radia- tion therapy for rectal carcer: Results from NSABP protocol R-01. J Natl Cancer Inst 1988;80:21-9.
• Gastrointestinal Study Group. Prolongation of the disease free interval in surgically treated rectal carcinoma. N Eng J Med 1985;312:1465-72.
• Krook JE, Moertel CG, Gunderson LL, et al. Effective surgi- cal adjuvant therapy for high-risk rectal carcinoma. N Eng J Med 1991;324:709-15.
• Lokich JJ, Ahlgren JD, Gullo JJ, et al.A Prospective rando­ mized comparison o f continuous infusion fluorouracil with a conventional bolus schedule in metastatic colorectal carci­ noma: A Mid-Atlantic Oncology Program Study. J d in Oncol 1989;7:425-32.
• Petrelli N, Dougtass HO, Herrera I, et al. The modulation of the fluorouracil with leucovorin in metastatic colorectal car­ cinoma: A prospective randomized phase III trial. J Clin Oncol 1989;7:1419-26.
• Piedbois P, Buyse M, Rustum Y, et al. Modulation o f fluo­ rouracil by leucovorin in patients with advanced colorectal cancer: evidence in terms o f response rate. J Clin Oncol 1992;10:896-903.