[Adjunct radiotherapeutic treatment following excision of rectal cancers].
As a whole, one out of 3 rectal cancers recurs after radical surgery. With or without metastases this recurrence causes the death of the patient because, with certain exceptions, surgery and radiotherapy are not effective. Post-operative radiotherapy, if effective locally and well tolerated, should improve the results. We have treated in this fashion 50 cases (with 45 Gy in standard spread) including A 2, 3 B1, 21 B2, 1 C1 and 23 C2 of Astler-Coller classification. With a follow-up of 40 to 100 months the recurrences concern 10% of B2 and 24% of C. The actuarial survival at 5 years is 66% with 75% for B2 and 54% for C. There are 4% of severe complications in the form of 2 perineal fistulae which required surgery. There are no small bowel complications due to the precautions to protect it. A review of the literature comparing 1,366 surgical procedures alone with 339 surgical procedures combined with post-operative radiotherapy in sufficient doses, shows that the recurrence rate decreases from 34% to 12% in case of irradiation. The survivals (actuarial, gross aggregate, or without evolutive disease) show practically in all cases an improvement of survival in case of irradiation.
Centre de traitement des Tumeurs, Hôpital Necker Enfants-Malades, Paris.
F
F
Baillet
D000230:Adenocarcinoma / Q000532:radiotherapy* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011379:Prognosis; D012004:Rectal Neoplasms / Q000532:radiotherapy* / Q000601:surgery
Traitement radiothérapique complémentaire après exérèse des cancers du rectum.