title: Advantages of the Papillon protocol in the preoperative treatment of rectal carcinoma.
abstract: Standard treatment for advanced rectal carcinoma currently includes surgery, radiotherapy, and chemotherapy. Although there are theoretic advantages to preoperative irradiation, it is often not performed because of the prolonged delay of surgery and the purported increase in perioperative complications. A pilot study was undertaken at our institution to evaluate a treatment protocol advocated by Dr. Papillon that offers a shorter treatment time and less patient morbidity than conventional preoperative therapy for rectal carcinoma. Twenty patients with rectal cancer underwent the preoperative regimen that consisted of 3,000 cGy delivered in 10 fractions over 12 days with concomitant 5-fluorouracil and mitomycin-C. Complications were acceptable. Local recurrence was lower than in most reported trials, and survival rates were comparable. Additional benefits of the protocol include lower radiation morbidity to the patient and a decreased delay between diagnosis and surgery.
authors.affiliation: Department of Surgery, University of Arkansas for Medical Sciences, Little Rock 72205.
authors.forename: V S
authors.initials: VS
authors.lastname: Klimberg
authors.forename: J D
authors.initials: JD
authors.lastname: Langston
authors.forename: A
authors.initials: A
authors.lastname: Maners
authors.forename: J C
authors.initials: JC
authors.lastname: Gocio
authors.forename: L F
authors.initials: LF
authors.lastname: Hutchins
authors.forename: N P
authors.initials: NP
authors.lastname: Lang
authors.forename: K C
authors.initials: KC
authors.lastname: Westbrook
authors.forename: J R
authors.initials: JR
authors.lastname: Broadwater
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010865:Pilot Projects; D011300:Preoperative Care; D011879:Radiotherapy Dosage; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D012007:Rectum / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors
chemical_list: D016685:Mitomycin; D005472:Fluorouracil