Adjuvant chemoirradiation for rectal cancer

Current Opinion in Gastroenterology

Volumn 13, Issue 1, 1997, Pages 11-17

  Gunderson, Leonard L ^a  

^a MAYO CLINIC   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTINEOPLASTIC AGENT; FLUOROURACIL; FOLINIC ACID;

CANCER ADJUVANT THERAPY; CANCER INVASION; CANCER RISK; CANCER SURVIVAL; HIGH RISK PATIENT; HUMAN; LYMPH NODE METASTASIS; POSTOPERATIVE CARE; PREOPERATIVE TREATMENT; RECTUM CANCER; RECURRENT CANCER; REVIEW; RISK FACTOR; SIDE EFFECT;

EID: 0031001914     PISSN: 02671379     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001574-199701000-00003     Document Type: Review

References (29)

1. Cummings B: Radiation treatment for rectal cancer. World J Surg 1995, 19:275-281. This is an excellent review article that discusses the role of irradiation as primary treatment.
2. Gunderson LL, Martenson JA, Haddock MG: Indications for and results of irradiation ± chemotherapy for rectal cancer. Ann Singapore Acad Med 1996, 25:448-459. This is a comprehensive review article that contains text and tabular data on randomized pre- and postoperative adjuvant trials for rectal cancer. It also presents single institution results on the relative roles of external irradiation ± chemotherapy ± intraoperative irradiation in the treatment of patients with locally advanced disease.
3. Sinicrope FA, Sugarman SM: Role of adjuvant therapy in surgically resected colorectal carcinoma. Gastroenterology 1995, 109:984-993.
4. Brierly JD, Cummings BJ, Wong CS, Keane TJ, O'Sullivan BO, Catton CN, Goodman P: Adenocarcinoma of the rectum treated by radical external radiation therapy. Int J Radiat Oncol Biol Phys 1995, 31:255-259. Excellent single institution data are presented on the use of external irradiation as a primary treatment modality for mobile and fixed rectal cancers.
5. Rich TA, Gunderson LL: Radical nonoperative treatment of early rectal cancer. Int J Radiat Oncol Biol Phys 1995, 31:677-678.
6. Holm T, Rutquist LE, Johansson H, Cedermark C: Abdominoperineal resection and anterior resection in the treatment of rectal cancer: results in relation to adjuvant preoperative radiotherapy. Br J Surg 1995, 82:1213-1216. The outcome of resection ± preoperative irradiation is presented for a group of 1292 patients from two consecutive, randomized trials. The addition of irradiation reduced local relapse and increased postoperative mortality and complications but had no impact on overall survival.
7. Myerson RJ, Michalski JM, King ML, Birnbaum E, Fleshman J, Fry R, Kodner I, Lacey D, Lockett MA: Adjuvant radiation therapy for rectal carcinoma: predictors of outcome, Int J Radiat Oncol Biol Phys 1995, 32:41-50. In a series of 307 patients treated with adjuvant irradiation, a multivariate analysis was performed to predict disease or treatment factors that favorably influenced disease control or survival.
8. Minsky BD, Cohen AC, Enker WE, Kelsen DP, Kemeny N, Frankel J: Efficacy of postoperative 5-FU high-dose leucovorin and sequential radiation therapy for clinically resectable rectal cancer. Cancer Invest 1995, 13:1-7.
9. Meade PG, Blatchford GJ, Thomson AG, Christenson MA, Tennent CA: Preoperative chemoirradiation downstages locally advanced ultrasound-staged rectal cancer. Am J Surg 1995, 170:609-613. In a series of 20 patients with T3 or T4 lesions treated with preoperative chemoirradiation (bolus 5-fluorouracil-10, infusion 5-fluorouracil-10), pathologically complete response was achieved in seven (35%).
10. Rich TA, Skibber TA, Ajani JA, Buchholz DJ, Cleary KR, Dubrow RA, Levin B, Lynch PM, Meterissian SH, Roubain LD, Ota D: Preoperative infusional chemoirradiation therapy for stage T3 rectal cancer, Int J Radiat Oncol Biol Phys 1995, 320:1025-1029. A pathologically complete response rate of 29% was achieved in a series of 77 patients using preoperative infusional chemoirradiation (5-fluorouracil plus 45 Gy) for T3 rectal cancers.
11. Aurelio P, Claudio C, Paolo M, Pierluigi G, Santina C, Domenico D, Numa C, Vincenzo V, Maurizio C, Fabrizio AI: Adjuvant treatment in operable stage II and III rectal cancer. Tumori 1995, 81:109-113.
12. Chari RS, Tyler DS, Anscher MS, Russell L, Clary BM, Hathorn J, Seigier HF: Preoperative radiation and chemotherapy in the treatment of adenocarcinoma of the rectum. Ann Surg 1995, 221:778-786. In a series of 42 patients treated with preoperative 5-fluorouracil cisplatin plus 45 Gy over 5 weeks, a pathologically complete response was achieved in 27% of patients.
13. Fortunate L, Ahmad NR, Yeung RS, Coia LR, Eisenberg BL, Sigurdson ER, Yeh K, Weese JL, Hoffman JP: Long-term follow-up of local excision and radiation therapy for invasive rectal cancer. Dis Colon Rectum 1995, 38:1193-1199.
14. Bucholz DJ, Lepek KJ, Rich TA, Murray D: 5-Fluorouracil-radiation interactions in human colon adenocarcinoma cells, Int J Radiat Oncol Biol Phys 1995, 32:1053-1058. Proliferating cells were shown to be more sensitive to radiosensitization with 5-fluorouracil than plateau phase cells, but this effect seemed to be independent of the cell cycle phase.
15. Minsky BD, Conti JA, Huang Y, Knopf K: Relationship of acute gastrointestinal toxicity and the volume of irradiated bowel in patients receiving combined modality therapy for rectal cancer. J Clin Oncol 1995, 13:1409-1416. Patients treated with postoperative chemoirradiation had a larger volume of small bowel within irradiation fields than those treated with preoperative chemoirradiation. The median of acute grade 3 gastrointestinal toxicity increased in relationship to the volume of small bowel within the irradiation field and higher doses of 5-fluorouracil.
16. Minsky B: Adjuvant radiation therapy for colon cancer. Cancer Treat Rev 1995, 21:407-414.
17. Fabian C, Giri S, Estes N, Tangen CM, Poplin E, Vogel S, Goodwin W, Rivkin S, Fleming TR, McDonald JS: Adjuvant continuous infusion 5-FU, whole abdominal radiation and tumor bed boost in high risk stage III colon carcinoma: a Southwest Oncology Group Pilot Study. Int J Radiat Oncol Biol Phys 1995, 32:457-464. This Southwestern Oncology Group pilot study of 41 patients resulted in higher disease control and survival rates than expected.
18. Estes NC, Gin S, Fabian C: Patterns of recurrence for advanced colon cancer modified by whole abdominal radiation and chemotherapy. Am Surg 1996, 62:546-550. Patients treated with whole abdomen plus tumor bed irradiation had a reduction in local, liver, and peritoneal relapse when compared with chemotherapy adjuvant treatment in Southwestern Oncology Group studies.
19. Willett CG, Shellito PC, Tepper JE, Eliseo R, Convery K, Wood WC: Intraoperative electron beam radiation therapy for primarily locally advanced rectal and rectosigmoid carcinoma. J Clin Oncol 1991, 9:843-849
20. Gunderson LL, Wolff BG, Cha S, Haddock MG, Schild SE, Devine RE, Martenson JA: Intraoperative irradiation for locally advanced primary and recurrent rectal cancer. Prob Gen Surg 1996, 12:93-105.
21. Gunderson LL, Nelson H, Martenson J, Cha S, Haddock M, Devine R, Fieck JM, Wolff B, Dozois R, O'Connell MJ: Locally advanced primary colorectal cancer: intraoperative electron and external beam irradiation ± 5-FU. Int J Radiat Oncol Biol Phys, in press. This series reports results in 56 patients with locally advanced primary colorectal cancers treated with IOERT-containing regimens at the Mayo Clinic in Rochester, MN. Favorable prognostic factors were identified for disease control and survival. A correlation was found between IOERT dose and the incidence and degree of peripheral neuropathy.
22. Weinstein GD, Rich TA, Shumate CR, Skibber JM, Cleary KR, Ajani JA, Ota DM: Preoperative infusional chemoirradiation and surgery with or without an electron beam intraoperative boost for advanced primary rectal cancer. Int J Radiat Oncol Biol Phys 1995, 32:197-204. Data from 38 patients with tethered T3 or T4 cancers treated with infusion 5-fluorouracil plus 45 Gy over 5 weeks suggest that disease control advantages for infusional chemoirradiation parallel those seen in an adjuvant setting.
23. Wallace HJ, Willett CGT, Shellito PC, Coen JJ, Hoover HC: Intraoperative radiation therapy for locally advanced recurrent rectal or rectosigmoid cancer. J Surg Oncol 1995, 60:122-127. Disease control and disease-free survival were better in the 27 patients in whom gross total resection could be achieved with negative or microscopically positive margins when compared to the 14 patients with gross residual.
24. Suzuki K, Gunderson LL, Devine RM, Weaver AL, Dozois RR, Ilstrup DM, Martenson JA, O'Connell MJ: Intraoperative irradiation after palliative resection for locally recurrent rectal cancer. Cancer 1995, 75:939-952. Of 106 patients, 42 had IOERT as a component of treatment at the Mayo Clinic. The IOERT patients had a 5-year survival advantage over non-IOERT patients of 19% versus 7% and a 3-year advantage of 43% versus 18% (P = 0.0006).
25. Magrini S, Nelson H, Gunderson LL, Sim FH: Sacropelvic resection and intraoperative irradiation in the management of recurrent anorectal cancer. Dis Colon Rectum 1996, 39:1-9.
26. Gunderson LL, Nelson H, Martenson JA, Cha S, Haddock M, Devine R, Fieck JM, Wolff B, Dozois R, O'Connell MJ: Intraoperative electron and external beam irradiation ± 5-FU and maximal resection for previously unirradiated locally recurrent colorectal cancer. Dis Colon Rectum 1996, 39:1379-1395. Results in 123 patients with locally recurrent, previously unirradiated colorectal cancers treated with IOERT-containing regimens at the Mayo Clinic are found in this report. Patients with gross residual disease after maximal resection had a 5-year actuarial survival rate of 18% versus 24% with microresidual disease.
27. Bussieres E, Gilly FN, Rouanet P, Mahe MA, Roussel A, Delannes M, Gerard JP, Dubois JB, Richaud P, on behalf of French Group of IORT: Recurrences of rectal cancers: results of a multimodel approach with intraoperative radiation therapy. Int J Radiat Oncol Biol Phys 1996, 34:49-56. Favorable disease control and survival results were seen in a subset of 30 patients who were previously unirradiated when presenting with local relapse.
28. Gunderson LL: Past, present and future of intraoperative irradiation for colorectal cancer. Int J Radiat Oncol Biol Phys 1996, 34:741-744.
29. Seifert WF, Wobbes T, Hoogenhout J, de Man BM, Huyben KMLC, Hendricks T: Intraoperative irradiation delays anastomotic repair in rat colon. Am J Surg 1995, 170:256-261.