Preoperative hyper-fractionated accelerated radiotherapy (HART) in locally advanced rectal cancer (LARC) immediately followed by surgery. A prospective phase II trial.

Détails

ID Serval
serval:BIB_F2112232A87B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Preoperative hyper-fractionated accelerated radiotherapy (HART) in locally advanced rectal cancer (LARC) immediately followed by surgery. A prospective phase II trial.
Périodique
Radiotherapy and Oncology
Auteur(s)
Coucke P.A., Notter M., Stamm B., Matter M., Fasolini F., Schlumpf R., Matzinger O., Bouzourene H., On Behalf Of All Surgeons From Public Hospitals And Private Clinics
ISSN
0167-8140
Statut éditorial
Publié
Date de publication
2006
Peer-reviewed
Oui
Volume
79
Numéro
1
Pages
52-58
Langue
anglais
Résumé
BACKGROUND AND PURPOSE: We aim to report on local control in a phase II trial on preoperative hyper-fractionated and accelerated radiotherapy schedule (HART) in locally advanced resectable rectal cancer (LARC). This fractionation schedule was designed to keep the overall treatment time (OTT) as short as possible. PATIENTS AND METHODS: This is a prospective trial on patients with UICC stages II and III rectal cancer. The patients were submitted to a total dose of 41.6 Gy, delivered in 2.5 weeks at 1.6 Gy per fraction twice a day with a 6-h interfraction interval. Surgery was performed within 1 week after the end of irradiation. Adjuvant chemotherapy was delivered in a subset of patients. RESULTS: Two hundred and seventy nine patients were entered and 250 are fully assessable, with a median follow-up of 39 months. The 5-years actuarial local control (LC) rate is 91.7%. The overall survival (OS) is 59.6%. The freedom from disease relapse (FDR) is 71.5%. Downstaging was observed in 38% of the tumors. CONCLUSION: The actuarial LC at 5 years is 91.7%, although we are dealing with stages II-III LARC, mainly located in the lower rectum (median distance = 5 cm). The pattern of failure is dominated by distant metastases and treatment intensification will obviously require a systemic approach.
Mots-clé
Dose Fractionation, Female, Humans, Male, Neoadjuvant Therapy, Neoplasm Staging, Prospective Studies, Quebec, Radiotherapy, Adjuvant, Rectal Neoplasms, Survival Analysis, Switzerland, Treatment Outcome
Pubmed
Web of science
Création de la notice
29/01/2008 19:32
Dernière modification de la notice
03/03/2018 22:39
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