title: Organ or sphincter preservation for rectal cancer. The role of contact X-ray brachytherapy in a monocentric series of 112 patients.
abstract: Contact X-ray brachytherapy (CXB) has been used at Centre Antoine Lacassagne since 2002 to increase the chance of conservative treatment (organ or sphincter preservation) in rectal cancer. A consecutive series of 112 patients (pts) is reported.
  
  
  
  Three protocols were used in selected rectal adenocarcinomas. Group 1: T1 N0 treated with local excision (LE) followed by adjuvant CXB. Group 2: T2 or 'early' T3 N0 treated with CXB combined with chemoradiotherapy (CRT) followed by surveillance or LE. Group 3: distal 'locally advanced' T3 N0-2 treated with CXB and CRT before total proctectomy.
  
  
  
  Group 1: 27 pt (pTis: 3; pT1: 21; pT2: 3). After LE with CXB alone (20 pt) or CXB + CRT (7 pt) one local recurrence occurred. Organ preservation was achieved in 26 pt (96%). Group 2: 45 pt (T1: 2; T2: 23; T3: 20) treated with CXB alone (4 pt) or CXB + CRT or external beam radiotherapy (EBRT) (41 pt). A clinical complete response (cCR) was observed in 43/45 (96%) and 3 pt developed a local recurrence (11% at 5 years). The specific survival was 76% at 5 years and the rate of organ preservation was 89% (40/45 pt) with good bowel function in 36 pt. Group 3: 40 pt, anterior resection (with sphincter preservation) was possible in 35 pt (86%) with a 3-year local recurrence of 6%.
  
  
  
  CXB usually combined as a boost with CRT or EBRT may safely increase the chance of a conservative treatment (organ or sphincter preservation) for selected rectal cancers.
authors.affiliation: CHU Nice, Department of Gastroenterology, Nice Sophia-Antipolis University, France.
authors.forename: Anne Claire
authors.initials: AC
authors.lastname: Frin
authors.affiliation: Centre Antoine Lacassagne, Department of Medical Oncology, Nice Sophia-Antipolis University, France.
authors.forename: Ludovic
authors.initials: L
authors.lastname: Evesque
authors.affiliation: Centre Antoine Lacassagne, Department of Research and Methodology, Nice Sophia-Antipolis University, France.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Gal
authors.affiliation: Centre Antoine Lacassagne, Department of Radiation Oncology, Nice Sophia-Antipolis University, France.
authors.forename: Karène
authors.initials: K
authors.lastname: Benezery
authors.affiliation: CHU Nice, Department of Gastroenterology, Nice Sophia-Antipolis University, France.
authors.forename: Eric
authors.initials: E
authors.lastname: François
authors.affiliation: CHU Nice, Department of Surgery, Nice Sophia-Antipolis University, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Gugenheim
authors.affiliation: CHU Nice, Department of Surgery, Nice Sophia-Antipolis University, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Benizri
authors.affiliation: Centre Antoine Lacassagne, Department of Research and Methodology, Nice Sophia-Antipolis University, France.
authors.forename: Yan
authors.initials: Y
authors.lastname: Château
authors.affiliation: Centre Antoine Lacassagne, Department of Radiation Oncology, Nice Sophia-Antipolis University, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Marcié
authors.affiliation: Centre Antoine Lacassagne, Department of Radiation Oncology, Nice Sophia-Antipolis University, France.
authors.forename: Jérome
authors.initials: J
authors.lastname: Doyen
authors.affiliation: Centre Antoine Lacassagne, Department of Radiation Oncology, Nice Sophia-Antipolis University, France. Electronic address: jean-pierre.gerard@nice.unicancer.fr.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Gérard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000473:pathology; D001918:Brachytherapy / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D059351:Organ Sparing Treatments / Q000379:methods*; D012004:Rectal Neoplasms / Q000532:radiotherapy*; D016019:Survival Analysis; D014964:X-Ray Therapy / Q000379:methods*
keywords: Conservative treatment; Contact X-ray brachytherapy; Organ preservation; Papillon treatment; Rectal cancer