Article
Is neoadjuvant chemotherapy benefical in surgical treatment of rectal cancer?
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Authors
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Johannes Ehrig
- Paul-Gerhardt-Stift, Lutherstadt Wittenberg, Deutschland
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A. Gabler
- Paul-Gerhardt-Stift, Lutherstadt Wittenberg
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J. Dunst
- Klinik für Strahlentherapie, Halle
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H. Zühlke
- Paul-Gerhardt-Stift, Lutherstadt Wittenberg
| Published: | March 20, 2006 |
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Outline
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Introduction: 5-year survival in rectal cancer is dependent on the occurrence of a local recurrence. It can be influenced on the one hand by exact adherence to surgical oncology practces, on the other hand by additional therapeutic regimes such as a combination of radiotherapy and systemic chemotherapy. Aside from timing, procedure of additional therapy and interval between radio-chemotherapy and surgical intervention, the following question question (issue) is in discussion: does neoadjuvant chemotherapy increase the rate of intra-surgical complications.
Material and methods: Experience is based a total of 20 patients: 11 patients participating in the Erlangen trial (combination of 5-FU and radiation), 6 patients enrolled in a Xeloda phase-II-trial and 3 patients from a pilot trial with oxaliplatin and Xeloda.
Results: All patients were judged as non-resectable based on an intensive pre-operative diagnostic regimen. Following neoadjuvant radio-chemotherapy, all patients could be treated surgically by TME-resection or amputation. Interventions were conducted by two surgeons. Intraoperative complications, which could be attributed to the neoadjuvant radio-chemotherapy, were not experienced in any of the patients. Pre-tumorous inflammation and tumor had regressed in all cases.
Conclusions: Intra-operative complications occurrred in none of the patients. Based on our experience, neoadjuvant radio-chemotherapy in its various modifictions does not constitute a hindrance for a radical surgical treatment.
