Concomitent Chemotherapy and radiotherapy in patients with Locally Advanced Rectal Carcinoma
Gaber, M., Alhashemee, M., Hassan, A., Hammam, S. (2019). Concomitent Chemotherapy and radiotherapy in patients with Locally Advanced Rectal Carcinoma. EKB Journal Management System, 23(Issue 1), 209-214. doi: 10.21608/smj.2019.43498
Mohmed Soliman Gaber; Mohamed Abo Elmagd Alhashemee; Al Sayed M Hassan; Sahar Noor Eldeen Hammam. "Concomitent Chemotherapy and radiotherapy in patients with Locally Advanced Rectal Carcinoma". EKB Journal Management System, 23, Issue 1, 2019, 209-214. doi: 10.21608/smj.2019.43498
Gaber, M., Alhashemee, M., Hassan, A., Hammam, S. (2019). 'Concomitent Chemotherapy and radiotherapy in patients with Locally Advanced Rectal Carcinoma', EKB Journal Management System, 23(Issue 1), pp. 209-214. doi: 10.21608/smj.2019.43498
Gaber, M., Alhashemee, M., Hassan, A., Hammam, S. Concomitent Chemotherapy and radiotherapy in patients with Locally Advanced Rectal Carcinoma. EKB Journal Management System, 2019; 23(Issue 1): 209-214. doi: 10.21608/smj.2019.43498

Concomitent Chemotherapy and radiotherapy in patients with Locally Advanced Rectal Carcinoma

Sohag Medical Journal
Article 33, Volume 23, Issue 1, January 2019, Page 209-214  XML PDF (270.6 K)
Document Type: Original Article
DOI: 10.21608/smj.2019.43498
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Authors
Mohmed Soliman Gaber1; Mohamed Abo Elmagd Alhashemee2; Al Sayed M Hassan3; Sahar Noor Eldeen Hammam4
1Department of Clinical Oncology , Faculty of Medicine, Sohag University.
2Department of surgical oncology , south Egypt cancer Institute
3Department of Clinical oncology, Faculty of Medicine, Sohag University, Sohag, Egypt.
4Department of oncology, Faculty of Medicine, Sohag University.
Abstract
Introduction:In recent years, the approach to adjuvant therapy for rectal cancer in the United States and Europe has been shifting toward preoperative therapy to promote sphincter-preserving surgery and decrease acute and late bowel toxicity.
Patients&Methods:This study will be a phase II trial to study the effectiveness of combining chemotherapy (Gemcitabine) and external – beam radiotherapy followed by surgery in treating patients who have locally advanced rectal cancer , It is carried on Sohag University Hospital & Sohag NCI since( October 2014- December2017),the dose of radiotherapy 5040 cGy /28ttt,and chemotherapy dose is 45mg/m2 given twice weekly during radiotherapy sessions only,  the study included 30 patients (age 18 and over), having rectal cancer with the following eligibility criteria:histologically proven ,previously untreated rectal carcinoma , every patient in the study was subjected to the following:history & physical examination,laboratory investigations, radiological studies.
 Results:Thirty patients were included in the study,13 females (43.3%) and 17 male( 56.6%)     mean of the age was 49 years. (range24-65year), most of them had adenocarcinoma of the rectum, the main presenting symptom was bleeding per rectum(56.7%), as regard to the response to the neoadjuvant treatmen 12/30 patients (40%) achieved Partial response,  8/30patients(27.6%) achieved complete  response and 10/30 patients (33%) had no response, abdomino - perineal resection was performed in 19 patients(63.3%)  and 11 patients (36.7%)  underwent sphincter preservation operation, about the toxicity in this study,for chemotherapy diarrhea was the most common manifestation which seen in 25 patients(83%),followed by loss of appetite seen in 9 patients(63.3%), for radiotherapy 19 patients (63%) developed wet desquamation. the  rate of Overall Survival of  the 2-years study is (80%),the Disease free survival is (63%)while the progression free survival is (72%),N stage was the only significant factor affecting the disease free survival and overall survival.
Conclusion: Pre-operative chemo-radiotherapy in dose and fractionation schedule used is safe, effective and well tolerated, allowed sphincter preservation which performed in (36.7%) of patients
Supplementary Files
References
  1.  Jakobsen A, Ploen J, Vuong T, Appelt A, Lindebjerg J, Rafaelsen SR. Dose-Effect Relationship in Chemoradiotherapy for Locally Advanced Rectal Cancer: A Randomized Trial Comparing Two Radiation Doses. Int J Radiat Oncol Biol Phys. 2012 May 15.
  2. Kahi CJ, Boland CR, Dominitz JA, Giardiello FM, Johnson DA, Kaltenbach T. Colonoscopy Surveillance After Colorectal Cancer Resection: Recommendations of the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2016 Mar. 150 (3):758-768.e11.
  3. Levin B, Lieberman DA, McFarland B . Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology 2008; 134:1570
  4. Meredith KL, Hoffe SE, Shibata D. The multidisciplinary management of rectal cancer. Surg Clin North Am. 2009 Feb. 89(1):177-215, ix-x.                                  Mini, E; Nobili, S; Caciagli, B; Landini, I; Mazzei, T (May 2006). "Cellular pharmacology of gemcitabine". Annals of Oncology.
  5. Mork ME, You YN, Ying J. High Prevalence of Hereditary Cancer Syndromes in Adolescents and Young Adults With Colorectal Cancer. J Clin Oncol 2015; 33:35
  6. Klabunde CN, Cronin KA, Breen N. Trends in colorectal cancer test use among vulnerable populations in the United States. Cancer Epidemiol Biomarkers Prev 2011; 20:161
  7. Wu S, Feng B, Li K. Fish consumption and colorectal cancer risk in humans: a   systematic review and meta-analysis. Am J Med 2012; 125:551
  8. Y Kanemitsu, T. Kato, T. Hirai et al., “Survival after curative resection for     mucinous adenocarcinoma of the colorectum,” Diseases of the Colon and Rectum, vol. 46, no. 2, pp. 160-167 2003
  9. van Helmond J, Beart RW. Cancer of the rectum: Operative management and adjuvant therapy. Current Therapy in Colon and Rectal Surgery. 2nd ed. Philadelphia, Pa: Mosby; 2005.
 

 

 

 

 

 

 

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