Abstract
If radiotherapy is considered in the management of a rectal cancer, there is very strong evidence supporting preoperative settings. To avoid treatment to cases where surgery alone is enough, exact preoperative staging with MRI is crucial.
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References
Påhlman L, Glimelius B (1984) Local recurrences after surgical treatment for rectal carcinoma. Acta Chir Scand 150:331–335
Glimelius B, Isacsson U, Jung B, Påhlman L (1997) Radiotherapy in addition to radical surgery in rectal cancer—evidence for a dose-response effect favouring preoperative treatment. Int J Radiat Oncol Biol Phys 37:281–287
Withers HR, Taylor JMC, Maciejewski B (1988) The hazard of accelerated tumor clonogen repopulation during radiotherapy. Acta Oncol 27:131–146
Camma C, Giunta M, Fiorica F, Pagliaro L, Craxi A, Cottone M (2000) Preoperative radiotherapy for resectable rectal cancer: a meta-analysis. JAMA 284:1008–1015
Glimelius B, Grönberg H, Järhult J, Wallgren A, Cavallin-Ståhl E (2003)Asystematic overview of radiation therapy in rectal cancer. Acta Oncologica 42; 476–492
Colorectal Cancer Collaborative Group (2001) Adjuvant radiotherapy for rectal cancer: a systematic overview of 8,507 patients from 22 randomised trials. Lancet 358:1291–1304
Påhlman L, Glimelius B (1990) Pre-or postoperative radiotherapy in rectal and rectosigmoid carcinoma—report from a randomized multicentre trial. Ann Surg 211:187–195
Krook JE, Moertel CG, Gunderson LL et al (1991) Effective surgical adjuvant therapy for high-risk rectal cancer. New Engl J Med 324:709–915
Gastrointestinal Tumor Study Group (1985) Prolongation of the disease-free interval in surgically treated rectal carcinoma. New Engl J Med 312:1464–1472
Tveit KM, Guldvog I, Hagen S et al (1997) Randomised controlled trial of postoperative radiotherapy and short-term time-scheduled 5-fluorouracil against surgery alone in the treatment of Dukes B and C rectal cancer. Br J Surg 84:1130–1135
Anonymous (1997) Improved survival with preoperative radiotherapy in resectable rectal cancer. Swedish Rectal Cancer Trial. New Eng J Med 336:980–987
Heald RJ, Karanjia ND. (1992) Results of radical surgery for rectal cancer. World J Surg 16:848–857
Enker WE (1992) Potency, cure, and local control in the operative treatment of rectal cancer. Arch Surg 127:1396–1401
Moriya Y, Hojo K, Sawada T, Koyama Y (1989) Significance of lateral node dissection for advanced rectal carcinoma at or below the peritoneal reflection. Dis Colon Rectum 32:307–315
Wibe A, Rendedal PR, Svensson E, Norstein J, Eide TJ, Myrvold HE, Soreide O(2002) Prognostic significance of the circumferential resection margin following total mesorectal excision for rectal cancer. Br J Surg 89:327–334
Dahlberg M, Glimelius B, Påhlman L (1999) Changing strategy for rectal cancer is associated with improved outcome. Br J Surg 86:379–384
Martling AL, Holm T et al (2000) Effect of a surgical training programme on the outcome of rectal cancer in the County of Stockholm. Lancet 356:93–96
Kapiteijn E, Marijnen CAM, Nagtegaal ID, Putter H, Steup WH, Wiggers T, Rutten HJT, Leer JWH, van Krieken JHJM, Påhlman L, Glimelius B, van de Velde CJH (2001) for the Dutch Colo Rectal Cancer Group and other cooperative investigators. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med 345:638–646
Swedish Rectal Cancer Register. http://www.SOS.se/mars/kva.ik.htm (Swe)
Påhlman L, Glimelius B (2002) Radiotherapy for rectal cancer: the European approach. In: Bleiberg H, Kemeny N, Rougier P, Wilke H-J (eds) Colorectal cancer: a clinical guide to therapy. Dunitz, London, pp 229–238
Dahlberg M, Glimelius B, Graf W, Påhlman L (1998) Preoperative irradiation for rectal cancer affects the functional results after colorectal anastomosis—results from the Swedish Rectal Cancer Trial. Dis Colon Rectum 41:543–551
Kollmorgen CF, Meagher AP, Pemberton JH et al (1994) The long-term effect of adjuvant postoperative chemoradiotherapy for rectal cancer on bowel function. Ann Surg 220:676–682
Akbari RP, Wong WD (2003) Endorectal ultrasound and the preoperative staging in rectal cancer. Scand J Surg 92:25–33
Brown G, Richards CJ, Newcombe RG et al (1999) Rectal carcinoma: thin-section MR imaging for staging in 28 patients. Radiology 211:215–222
Beets-Tan RGH, Beets GL, Vliegen RFA et al (2001) Accuracy of magnetic resonance imaging in prediction of tumour-free resection margin in rectal cancer surgery. Lancet 357:497–504
Adam IJ, Mohamdee MO, Martin IG et al (1994) Role of circumferential resection margin involvement in the local recurrence of rectal cancer. Lancet 344:707–711
Nagtegaal ID, van de Velde CJH, van der Worp E, Kapiteijn E, Phil Quirke J, van Krieken J, Han JM (2002) Macroscopic evaluation of rectal cancer resection specimen: clinical significance of the pathologist in quality control. J Clin Onc 20:1729–1734
Påhlman L, Enblad P, Glimelius B (1985) Clinical characteristics and their relation to surgical curability in adenocarcinoma of the rectum and recto-sigmoid: a population-based study in 279 consecutive patients. Acta Chir Scand 151:685–693
Moertel CG, Childs DS, Reitemeier RJ et al (1969) Combined 5-fluorouracil and supervoltage radiation therapy of locally unresectable gastrointestinal carcinoma. Lancet 2:865–867
Overgaard M, Berthelsen K, Dahlmark M, Gadeberg CG, van der Maase H, Overgaard J, Sell A (1989) A randomized trial of radiotherapy alone or combined with 5-FU in the treatment of locally advanced colorectal carcinoma (abstract). ECCO 5 meeting, 0-0626, Vienna
Wassif-Boulis S (1982) The role of preoperative adjuvant therapy in management of borderline operability of rectal cancer. Clin Radiol 33:353–358
Frykholm GJ, Pahlman L, Glimelius B (2001) Combined chemo and radiotherapy versus radiotherapy alone in the treatment of primary, non-resectable adenocarcinoma of the rectum. Int J Rad Onc Biol Phys 50:433–440
Janjan NA, Abbruzzese J, Pazdur R, Khoo VS, Cleary K, Dubrow R, Ajani J, Rich TA, Goswitz MS, Evetts PA, Allen PK, Lynch PM, Skibber JM (1999) Prognostic implications of response to preoperative infusional chemoradiation in locally advanced rectal cancer. Radiother Oncol 51:153–160
Bouzourene H, Bosman FT, Seelentag W, Matter M, Coucke P (2002) Importance of tumor regression assessment in predicting the outcome in patients with locally advanced rectal carcinoma who are treated with preoperative radiotherapy. Cancer 94:1121–1130
Glynne-Jones R, Sebag-Montefiore D (2002) Chemoradiation schedules—what radiotherapy? Eur J Cancer 38:258–569
Rouanet P, Saint-Aubert B, Lemanski C et. al (2002) Restorative and nonrestorative surgery for low rectal cancer after high-dose radiation. Dis Colon Rectum 45:305–315
Mohiuddin M, Regine WF, Marks GJ, Marks JW (1998) High dose preoperative radiation and the challenge of sphincter-preservation surgery for rectal cancer of the distal 2 cm of the rectum. Int J Radiat Oncol Biol Phys 40:569–574
Habr-Gama A, de Souza PM, Ribeiro U et al (1998) Low rectal cancer: impact of radiation and chemotherapy on surgical treatment. Dis Colon Rectum 41:1087–1096
Moore HG, Riedel E, Minsky BD et al (2003) Adequacy of 1 cm distal margin after restorative rectal cancer resection with sharp mesorectal excision and preoperative combined-modality therapy. Ann Surg Oncol 1:80–85
Karnjia ND, Schache DJ, Nort WR, Heald RJ (1990) 'Close shave’ in anterior resection. Br J Surg 63:673–677
Francois Y, Nemoz CJ, Baulieux J et al (1999) Influence of the interval between preoperative radiation therapy and surgery on downstaging and on the rate of sphincter-sparing surgery for rectal cancer: the Lyon R90-01 randomized trial. J Clin Oncol 17:2396–2402
Bujko K, Nowacki MP, Bebenek M et al (2004) Sphincter preservation following preoperative radiotherapy for rectal cancer: report of a randomised trial comparing short-term radiotherapy versus conventionally fractionated radiochemotherapy. Radiation Oncol 72:15–24
Frigell A, Ottander M, Stenbeck H, Påhlman L (1990) Quality of life of patients treated with abdominoperineal resection or anterior resection for rectal carcinoma. Ann Chir Gynaecol 79:26–30
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Påhlman, L. (2005). Indications for Neoadjuvant Long-Term Radiotherapy. In: Büchler, M.W., Weitz, J., Ulrich, B., Heald, R.J. (eds) Rectal Cancer Treatment. Recent Results in Cancer Research, vol 165. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-27449-9_23
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DOI: https://doi.org/10.1007/3-540-27449-9_23
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