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Neoadjuvant vs adjuvant pelvic radiotherapy for locally advanced rectal cancer: Which is superior? 被引量:10

Neoadjuvant vs adjuvant pelvic radiotherapy for locally advanced rectal cancer: Which is superior?
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摘要 The treatment of locally advanced rectal cancer including timing and dosage of radiotherapy, degree of sphincter preservation with neoadjuvant radiotherapy, and short and long term effects of radiotherapy are controversial topics. The MEDLINE, Cochrane Library databases, and meeting proceedings from the American Society of Clinical Oncology, were searched for reports of randomized controlled trials and meta-analyses comparing neoadjuvant and adjuvant radiotherapy with surgery to surgery alone for rectal cancer. Neoadjuvant radiotherapy shows superior results in terms of local control compared to adjuvant radiotherapy. Neither adjuvant or neoadjuvant radiotherapy impacts overall survival. Short course versus long course neoadjuvant radiotherapy remains controversial. There is insufficient data to conclude that neoadjuvant therapy improves rates of sphincter preserving surgery. Radiation significantly impacts anorectal and sexual function and includes both acute and long term toxicity. Data demonstrate that neoadjuvant radiation causes less toxicity compared to adjuvant radiotherapy, and specifically short course neoadjuvant radiation results in less toxicity than long course neoadjuvant radiation. Neoadjuvant radiotherapy is the preferred modality for administering radiation in locally advanced rectal cancer. There are significant side effects from radiation, including anorectal and sexual dysfunction, which may be less with short course neoadjuvant radiation. The treatment of locally advanced rectal cancer including timing and dosage of radiotherapy, degree of sphincter preservation with neoadjuvant radiotherapy, and short and long term effects of radiotherapy are controversial topics. The MEDLINE, Cochrane Library databases, and meeting proceedings from the American Society of Clinical Oncology, were searched for reports of randomized controlled trials and meta-analyses comparing neoadjuvant and adjuvant radiotherapy with surgery to surgery alone for rectal cancer. Neoadjuvant radiotherapy shows superior results in terms of local control compared to adjuvant radiotherapy. Neither adjuvant or neoadjuvant radiotherapy impacts overall survival. Short course versus long course neoadjuvant radiotherapy remains controversial. There is insufficient data to conclude that neoadjuvant therapy improves rates of sphincter preserving surgery. Radiation significantly impacts anorectal and sexual function and includes both acute and long term toxicity. Data demonstrate that neoadjuvant radiation causes less toxicity compared to adjuvant radiotherapy, and specifically short course neoadjuvant radiation results in less toxicity than long course neoadjuvant radiation. Neoadjuvant radiotherapy is the preferred modality for administering radiation in locally advanced rectal cancer. There are significant side effects from radiation, including anorectal and sexual dysfunction, which may be less with short course neoadjuvant radiation.
机构地区 Department of Surgery
出处 《World Journal of Gastroenterology》 SCIE CAS CSCD 2011年第7期848-854,共7页 世界胃肠病学杂志(英文版)
关键词 Locally advanced rectal cancer Neoadjuvant radiation Adjuvant radiation Rectal neoplasm CHEMORADIOTHERAPY Neoadjuvant chemoradiotherapy 直肠癌 放疗 晚期 Medline 盆腔 随机对照试验 放射治疗 性功能障碍
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同被引文献53

  • 1Tony Wing Chung Mak,Janet Fung Yee Lee,Kaori Futaba,Sophie Sok Fei Hon,Dennis Kwok Yu Ngo,Simon Siu Man Ng.Robotic surgery for rectal cancer: A systematic review of current practice[J].World Journal of Gastrointestinal Oncology,2014,6(6):184-193. 被引量:16
  • 2Stephane Supiot,Wilfried Gouraud,Loc Campion,Pascal Jezéquel,Bruno Buecher,Josiane Charrier,Marie-Francoise Heymann,Marc-Andre Mahé,Emmanuel Rio,Michel Chérel.Early dynamic transcriptomic changes during preoperative radiotherapy in patients with rectal cancer: A feasibility study[J].World Journal of Gastroenterology,2013,19(21):3249-3254. 被引量:3
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