scholarly journals Clinical Effect of Radiotherapy Combined with Capecitabine after Neoadjuvant Therapy for Rectal Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Qibo Zhang ◽  
Haibin Teng
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Adverse Reactions ◽  
Clinical Effect ◽  
Statistical Significance ◽  
Progression Free Survival ◽  
Control Group ◽  
Free Survival ◽  
Experimental Group

Objective. The purpose of the study was to investigate the clinical effect of radiotherapy combined with capecitabine in rectal cancer patients after neoadjuvant therapy. Methods. 80 rectal cancer patients who underwent neoadjuvant therapy in our hospital from February 2016 to February 2018 were selected as the study subjects and divided into the control group (n = 40) and experimental group (n = 40) according to the order of admission. Among them, the control group was treated with radiotherapy, while the experimental group was treated with radiotherapy combined with capecitabine. The therapeutic efficacy, CEA levels, the incidence and recurrence rate of adverse reactions, as well as the progression-free survival and survival rate after 2-year treatment were analyzed in the two groups. Results. The effective rate of treatment in the experimental group of 87.5% (35/40) was significantly higher than 50% (20/40) in the control group, with statistical significance (X2 = 13.09, P < 0.001 ). After treatment, the CEA levels in the two groups both decreased significantly, and the CEA level in the experimental group of 3.75 ± 1.76 ng/ml was significantly lower than 7.35 ± 2.11 ng/ml in the control group, with statistical significance (T = 8.29, P < 0.001 ). The incidence and the recurrence rate of adverse reactions of 5% (2/40) and 10% (4/40), respectively, in the experimental group were significantly lower than those of 40% (16/40) and 30% (12/40) in the control group, with statistical significance (X2 = 14.05, 5.00, P < 0.001 , 0.05). After the 2-year follow-up, it was found that the progression-free survival of 21.53 ± 6.23 months in the experimental group was significantly longer than that of 18.18 ± 5.41 months in the control group, with statistical significance (T = 2.57, P < 0.05 ), and the 2-year survival rate of 97.5% (39/40) in the experimental group was significantly higher than 80% (32/40) in the control group, with statistical significance (T = 6.13, P < 0.05 ). Conclusion. Radiotherapy combined with capecitabine in rectal cancer patients after neoadjuvant therapy can improve the therapeutic efficacy with fewer adverse reactions and longer patients’ survival, which is worthy of popularization and application after neoadjuvant therapy for rectal cancer.

scholarly journals Combination of apatinib mesylate and second-line chemotherapy for treating gastroesophageal junction adenocarcinoma

2019 ◽  
Vol 47 (5) ◽  
pp. 2207-2214 ◽  
Author(s):  
Bin Lu ◽  
Chaoyun Lu ◽  
Zheng Sun ◽  
Caiping Qu ◽  
Ji Chen ◽  
...  
Keyword(s):  
Adverse Reactions ◽  
Remission Rate ◽  
Gastroesophageal Junction ◽  
Progression Free Survival ◽  
Control Group ◽  
Free Survival ◽  
Gastroesophageal Junction Adenocarcinoma ◽  
Experimental Group ◽  
Total Remission ◽  
Line Chemotherapy

Objective To investigate the safety and efficacy of acitinib mesylate combined with chemotherapy in the treatment of patients with gastroesophageal junction adenocarcinoma. Methods A total of 119 patients with gastroesophageal junction adenocarcinoma were enrolled and randomized into an experimental group (n = 60) and a control group (n = 59). Both groups were treated with a combination of taxane, irinotecan and fluorouracil, while the experimental group also received acitinib mesylate. The clinical efficacy, survival time and adverse reactions of patients in two groups were recorded and analyzed. Results The total remission rate in the experimental group and the control group was 15.79% and 3.23%, respectively; the disease control rate was 73.68% and 54.84%, respectively; and progression-free survival was 3.72 months (1–13.5 months) and 3.04 months (1–6 months), respectively. Overall survival was 13.66 months (5–24 months) and 10.08 months (6.5–19.5 months), in the experimental group and the control group, respectively. In addition, the incidence of adverse events in the experimental group was significantly lower than that in the control group. Conclusion Apatinib mesylate combined with chemotherapy for the treatment of patients with gastroesophageal junction adenocarcinoma was safe and effective, with improved survival benefit compared with control.

scholarly journals Pathological Response Has Survival Benefits for Rectal Cancer following Neoadjuvant Therapy

2019 ◽  
Author(s):  
Wei-Chih Chen ◽  
Li-Jen Kuo ◽  
Chia-Che Chen ◽  
Po-Li Wei ◽  
Yu-Min Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Overall Survival ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Associated Factors ◽  
Disease Recurrence ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
N Stage

Abstract Background Studies reporting the results of associated factors of pathological completed response (PCR) and tumor regression response in patients with rectal cancer following neoadjuvant chemoradiation therapy (nCRT) are inconsistent. The purpose of this study was to identify the prognostic factors of tumor response and outcome in rectal cancer patients.Methods The study was a retrospective analysis. Patients with locally advanced rectal cancer underwent nCRT followed by surgery from 2010 to 2014 with 5 years of follow-up. The primary outcomes were associated factors of pathological completed response and downstaging. The risk factors of survival outcome and disease recurrence were also observed.Results A total of 169 rectal cancer patients were included. The PCR rate was 17.8%, and the downstaging rate was 60.9%. Patients with a histology type of adenocarcinoma associated with PCR, and patients positive for clinical N stage were associated with downstaging. Kaplan-Meier analysis showed the PCR group performed better to a statistically significant level both in overall survival and disease recurrence free survival than the no PCR group (p= 0.033 & 0.025, respectively). Patients with a downstaging response also showed better overall survival benefits and disease recurrence free survival benefits than their counter-parts (both p<0.001). After controlling confounding variables, the risk factors of overall survival were downstaging [Hazard Ratio (HR): 0.40, 95% CI: 0.21-0.74], male, abnormal post-nCRT CEA level and abnormal Hb level. In addition, the protective factors of recurrence were downstaging and having adjuvant chemotherapy.Conclusions Among rectal cancer patients who received the neoadjuvant therapy, histology type and clinical N stage were associated with PCR and downstaging, respectively. Downstaging was an important protective factor for better overall survival and recurrence free survival.

scholarly journals Effect of Entecavir Combined with Adefovir Dipivoxil on Clinical Efficacy and TNF-α and IL-6 Levels in Patients with Hepatitis B Cirrhosis

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Yonghuan Yu ◽  
Xinfeng Cui ◽  
Jingjing Zhao ◽  
Ting Jia ◽  
Baofeng Ren ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Hepatitis B ◽  
Liver Function ◽  
Adefovir Dipivoxil ◽  
Adverse Reactions ◽  
Statistical Significance ◽  
Effective Rate ◽  
Control Group ◽  
Tnf Α ◽  
Experimental Group

Objective. The purpose of the study was to investigate the effect of entecavir combined with adefovir dipivoxil on clinical efficacy and TNF-α and IL-6 levels in patients with hepatitis B cirrhosis. Methods. A total of 100 patients with hepatitis B cirrhosis admitted to our hospital between January 2018 and June 2019 were randomly selected and divided into the control group (n = 50) and experimental group (n = 50) according to the order of admission. Among them, the control group patients were treated with entecavir, while the patients in the experimental group received entecavir combined with adefovir dipivoxil. After that, the effective rate of treatment, the incidence of adverse reactions, liver function indexes, liver fibrosis condition, and TNF-α and IL-6 expression levels were all compared between the two groups. Results. The effective rate of treatment in the experimental group was significantly higher than that in the control group, with statistical significance ( p < 0.001 ); the incidence of adverse reactions of the patients in the experimental group was significantly lower than that in the control group, with statistical significance ( p < 0.001 ); the liver function indexes in the experimental group were significantly better than those in the control group, with statistical significance ( p < 0.001 ); the number of patients with liver fibrosis in the experimental group was significantly less than that in the control group, with statistical significance ( p < 0.001 ); the TNF-α and IL-6 expression levels in the experimental group were significantly lower than those in the control group, with statistical significance ( p < 0.001 ). Conclusion. Entecavir combined with adefovir dipivoxil in the treatment of hepatitis B cirrhosis can effectively improve the therapeutic effect and reduce the serum inflammatory factor levels, with high safety, which is worthy of application and popularization.

scholarly journals Dose-dense weekly paclitaxel and carboplatin compared with conventional paclitaxel and carboplatin treatment for stage II-IV ovarian cancer patients

2015 ◽  
Vol 10 (3) ◽  
pp. 489
Author(s):  
Zhenhua Du ◽  
Xiaolin Ma
Keyword(s):  
Ovarian Cancer ◽  
Cancer Patients ◽  
Statistical Significance ◽  
Progression Free Survival ◽  
Stage Ii ◽  
Weekly Paclitaxel ◽  
Free Survival ◽  
Clinical Responses ◽  
Dose Dense ◽  
To Receive

<p>We investigated dose-dense weekly paclitaxel and carboplatin compared with conventional paclitaxel and carboplatin treatment on stage II-IV ovarian cancer patients. Between July, 2011, and October, 2014, a total of 221 patients was randomly assigned to receive dose-dense weekly paclitaxel and carboplatin group (n = 109) and conventional paclitaxel and carboplatin group (n = 112), just after the sixth chemotherapy cycles, and at 12 months after randomization. Median progression-free survival (PFS) was 16.8 months (range 3.3-48+ months) of conventional paclitaxel and carboplatin group was lower than that of dose-dense weekly paclitaxel and carboplatin group 27.6 months (range 4.2-51+ months). But, these clinical responses were not statistical significance in each group. In conclusion, dose-dense weekly paclitaxel and carboplatin treatment improves survival compared with conventional paclitaxel and carboplatin treatment. </p>

scholarly journals Chinese Medicine Combined With EGFR-TKIs Prolongs Progression-Free Survival and Overall Survival of Non-small Cell Lung Cancer (NSCLC) Patients Harboring EGFR Mutations, Compared With the Use of TKIs Alone

2021 ◽  
Vol 9 ◽  
Author(s):  
Yujia Wang ◽  
Guoyu Wu ◽  
Ru Li ◽  
Yingzhe Luo ◽  
Xingmei Huang ◽  
...  
Keyword(s):  
Egfr Mutation ◽  
Progression Free Survival ◽  
Deletion Mutation ◽  
Control Group ◽  
Small Cell Lung ◽  
Free Survival ◽  
Exon 19 Deletion ◽  
Nsclc Patients ◽  
Experimental Group ◽  
Egfr Tkis

Objective: To explore the efficacy comparison between epidermal growth factor receptor–tyrosine kinase inhibitors (EGFR-TKIs) combined with traditional Chinese medicine (TCM) and single EGFR-TKIs for advanced non-small cell lung cancer (NSCLC).Methods: A total of 91 NSCLC patients with EGFR mutation were divided into an experimental group and a control group (in a ratio of 2:1) to receive TCM and EGFR-TKIs (61 cases) or single EGFR-TKIs (30 cases). Patients in the control group took EGFR-TKIs and those in the experimental group took EGFR-TKIs plus TCM. We analyzed the progression-free survival (PFS), overall survival (OS), disease control rate (DCR), and treatment-related adverse events of two groups.Results: The mPFS of the experimental group and the control group was 12.3 and 8.9 months (P = 0.02), respectively, and the mOS of the experimental group and the control group was 28.2 and 24.2 months (P = 0.02), respectively. Subgroup analysis showed that for the patients with exon 19 deletion mutation (19DEL), mPFS between experimental group and control group was 12.7 and 10.1 months, respectively (P = 0.12). For exon 21 deletion mutation (L858R), the PFS of two groups was 10.8 vs. 8.2 months, respectively (P = 0.03). The subgroup analysis also showed that, for the patients with exon 19 deletion mutation, mOS between the experimental group and the control group was 30.3 and 28.7 months, respectively (P = 0.19). For exon 21 deletion mutation, the mOS of two groups was 25.5 vs. 21.3 months, respectively (P = 0.01). The DCR of the experimental group and the control group was 93.3% and 80.1%, respectively (P = 0.77). Grade 3–4 treatment-related adverse events were less common with the experimental group (11.48%) than the control group (26.67%).Conclusion: For NSCLC patients with EGFR mutation, EGFR-TKIs combined with TCM had a certain effect to prolong mPFS and mOS, compared with the use of EGFR-TKIs alone, especially for the patients with L858R. This conclusion has a significant effect on improving the survival of NSCLC patients after EGFR-TKIs resistance. It deserves further study.

Baseline lymphopenia as a prognostic marker for colorectal carcinoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14107-e14107
Author(s):  
Dilek Erdem ◽  
Idris Yucel ◽  
Bahiddin Yilmaz ◽  
Guzin Demirag ◽  
Yasemin Kemal ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Lymphocyte Count ◽  
Statistical Significance ◽  
Disease Free Survival ◽  
Progression Free Survival ◽  
Hematological Toxicity ◽  
Free Survival ◽  
Increased Risk ◽  
Colorectal Cancer Patients

e14107 Background: Baseline lymphopenia has been proved to be a marker for poor prognosis, chemotherapy-induced toxicity and increased risk of febrile neutropenia, trombocytopenia and anemia in advanced solid neoplasms. This study aims to evaluate the effect of pretreatment lymphopenia on prognosis and hematological toxicity in colorectal cancer patients who received first line systemic chemotherapy. Methods: Lymphocyte count was evaluated in 386 pretreated colorectal cancer patients who do not have a seconder malignancy, HIV infection, bone involvement and primary G-CSF prophylaxis. Overall survival, progression free survival and disease free survival were calculated from date of diagnosis to date of relapse, progression and death. Kaplan-Meier, chi-square and Student-t test were used. Results: Mean follow-up was 30 months (range 1-180 months). Mean age was 57.4±12.5 years. Of all patients, 160 (41 %) were women. Rectum ( 26.2 %) and transvers colon (4.7 %) were the most and the least common anatomic locations, respectively. Mean lymphocyte count before treatment was 1964/µl (170-7000/µl). There were no relationship between lymphopenia and age, sex, performans status, presence of initial metastasis, adjuvant or palliative chemotherapy and hematological toxicity (p>0.05). Grade 3-4 hematological toxicity was found in 40 patients and was significantly higher in patients receiving bi- or tri-chemotherapy regimen (p:0.017). Among 208 patients with relapse or progression, 40 patients had lymphopenia (19.2 %). 1, 3 and 5-year OS were significantly lower in lymphopenic patients (p:0.033). DFS was longer in non-lymphopenic patients but this data didn’t have statistical significance (p>0.05). Conclusions: This study support that lymphocyte number prior to chemotherapy may be a simple but useful prognostic and predictive marker in untreated colorectal cancer patients. Patients with lower pretreatment lymphopenia have lower OS when compared to others (p<0.05). This study has the highest colorectal cancer population in the literature.

scholarly journals The effects and safety of pirfenidone in the treatment of idiopathic pulmonary fibrosis: a meta-analysis and systematic review

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Chenchen Zang ◽  
Yan Zheng ◽  
Yanqing Wang ◽  
Lisha Li
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Vital Capacity ◽  
Adverse Reactions ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Control Group ◽  
High Quality ◽  
Free Survival ◽  
Randomized Controlled

Abstract Background It is necessary to systematically evaluate the efficacy and adverse reactions of pirfenidone in the treatment of patients with idiopathic pulmonary fibrosis (IPF). Methods Pubmed et al. databases were searched up to March 15, 2021 for randomized controlled trials (RCT) of pirfenidone in the treatment of IPF. Two authors collected and compared the indicators including progression-free survival (PFS), vital capacity (VC), forced vital capacity (FVC), and adverse reactions. RevMan 5.3 software and Stata 15.0 software were used for meta-analysis. Results A total of 8 reports with 9 RCTs involving 1824 IPF patients were included. Meta-analysis results showed that compared with the control group, pirfenidone could prolong the PFS phase of IPF patients (HR = 0.65, 95% CI 0.55 ~ 0.76, P < 0.001), slow down the VC of IPF patients (SMD = 0.43, 95% CI 0.21 ~ 0.66, P < 0.001), and decrease FVC (SMD = 0.31, 95% CI 0.14 ~ 0.48, P < 0.001). The main adverse reactions of pirfenidone were gastrointestinal reactions, photosensitivity and skin rashes. Conclusion Pirfenidone is beneficial to prolong the PFS of IPF patients, improve lung function, and it is safe for clinical use. However, more high-quality RCTs are still needed to provide reliable evidence for the treatment of IPF.

scholarly journals Pathological Response Has Survival Benefits for Rectal Cancer following Neoadjuvant Therapy

2020 ◽  
Author(s):  
Wei-Chih Chen ◽  
Li-Jen Kuo ◽  
Chia-Che Chen ◽  
Po-Li Wei ◽  
Yu-Min Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Overall Survival ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Associated Factors ◽  
Disease Recurrence ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
N Stage

Abstract Background: Studies reporting the results of associated factors of pathological completed response (PCR) and tumor regression response in patients with rectal cancer following neoadjuvant chemoradiation therapy (nCRT) are inconsistent. Objective: The purpose of this study was to identify the prognostic factors of tumor response and outcome in rectal cancer patients. Design: The study was a retrospective analysis. Settings: The study was conducted in a single large institution in Taiwan. Patients: Newly diagnosed rectal cancer patients who underwent nCRT followed by surgery from 2010 to 2014 with 5 years of follow-up. Main Outcome Measures: The primary outcomes were associated factors of pathological completed response and downstaging. The risk factors of survival outcome and disease recurrence were also observed. Results: A total of 169 rectal cancer patients were included. The PCR rate was 17.8%, and the downstaging rate was 60.9%. Patients with a histology type of adenocarcinoma associated with PCR, and patients positive for clinical N stage were associated with downstaging. Kaplan-Meier analysis showed the PCR group performed better to a statistically significant level both in overall survival and disease recurrence free survival than the no PCR group (p= 0.033 & 0.025, respectively). Patients with a downstaging response also showed better overall survival benefits and disease recurrence free survival benefits than their counterparts (both p<0.001). After controlling confounding variables, the risk factors of overall survival were downstaging [Hazard Ratio (HR): 0.40, 95% CI: 0.21-0.74], male, abnormal post-nCRT CEA level and abnormal Hb level. In addition, the protective factors of recurrence were downstaging and having received adjuvant chemotherapy. Limitations: Modest sample size and limited genetic bio-markers information. Conclusions: Among rectal cancer patients who received the neoadjuvant therapy, histology type and clinical N stage were associated with PCR and downstaging, respectively. Downstaging was an important protective factor for better overall survival and recurrence free survival.

Relationship of lymphopenia to overall survival and progression-free survival in rectal cancer patients receiving neoadjuvant chemoradiation.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 39-39
Author(s):  
Jackson Neal Howell ◽  
Bailey Nelson ◽  
David Cady ◽  
Jordan Kharofa
Keyword(s):  
Rectal Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Progression Free Survival ◽  
Neoadjuvant Chemoradiation ◽  
Preoperative Chemoradiation ◽  
Small Sample ◽  
Pathologic Response ◽  
Surgical Patient ◽  
Free Survival

39 Background: Pelvic radiation and myelosuppressive chemotherapy can lead to lymphopenia during the course of preoperative chemoradiation when treating rectal cancer. Lymphopenia during chemoradiation has been associated with higher risks of recurrence in other cancers, possibly due to decreased immunosurveillance. The effect in rectal cancer is not well described. We hypothesize that high-grade lymphopenia is associated with worse progression-free survival (PFS) and overall survival (OS) in rectal cancer patients undergoing preoperative chemoradiation. Methods: All patients treated at our institution with neoadjuvant chemoradiation between 2013 and 2019 were reviewed (n = 99). The study was limited to patients with Stage II – IV (AJCC 8th edition) rectal adenocarcinoma. Patients were excluded if they had prior systemic therapy (n = 13) or if lymphocyte data was unavailable (n = 30). Lymphopenia which arose during or within 30 days of completion of chemoradiation was graded by the CTCAE v.4.0. Neoadjuvant Rectal (NAR) scores, indicators of pathologic response, were calculated for each surgical patient. Kaplan-Meier analysis was used to calculate PFS and OS. Two-tailed t-tests (a=0.05) were used to detect differences between subgroups. Results: Fifty-six patients met inclusion criteria. Grade 2 (G2) or higher lymphopenia occurred in 43 (76.8%) patients (G2 = 22, G3 = 20, G4 = 1). In patients with G2 vs G3-4 lymphopenia, there were no differences in baseline, treatment, or demographic characteristics. The median PFS for these patients was 20.0 months. Patients with G3-4 lymphopenia had significantly worse 2-year PFS compared to those with G2 lymphopenia (83.3% vs 59.3% p = 0.03). The two-year OS did not differ between groups (100% vs 60.3%, p = 0.10). Lymphocyte nadir did not correlate with pathologic response, as measured by the NAR score (r = -0.28, p = 0.07). Conclusions: In this study, G3-4 lymphopenia was associated with worse PFS in rectal cancer patients treated with neoadjuvant chemoradiation, despite a small sample size. The prognostic implications of lymphopenia in rectal cancer should be confirmed in larger cohorts and the underlying mechanisms explored.

THE FEASIBILITY OF COMBINED TREATMENT OF COMPLICATED LOCALLY ADVANCED AND RECURRENT RECTAL CANCER. CASE-CONTROL STUDY

2019 ◽  
Vol 65 (2) ◽  
pp. 263-271
Author(s):  
Valeriy Ivanov ◽  
Sergey Gordeev ◽  
Zaman Mamedli ◽  
Sergey Tkachev ◽  
Dmitriy Kuzmichev ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Combined Treatment ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Complete Response ◽  
Recurrent Rectal Cancer ◽  
Control Group ◽  
Study Group ◽  
Free Survival ◽  
Control Study

INTRODUCTION: The goal of the study was to assess the feasibility of combined treatment in patients with a complicated course of locally advanced and recurrent colorectal cancer. METHODS: A case-control study was conducted. The study group included patients with locally advanced or recurrent rectal cancer complicated by external, rectovesical, rectovaginal fistulas and/or peritumoral abscesses received neoadjuvant chemoradiation (CRT). Patients without complications comparable to the study group by sex, age, ECOG status, cT value, and the nature of the tumor (primary/recurrent) treated with neoadjuvant CRT were selected in the control group. The primary end points of the study were CRT toxicity (NCI-CTC v.4.0) and postoperative complications (Clavien-Dindo). The secondary endpoints of the study were the pathologic complete response rate 2-year progression-free survival. RESULTS: 21 patients were included in both groups. In the study group the following complications were noted: external fistula (n = 7), rectovaginal fistula (n = 6), rectovesical fistula (n = 4), paraproctitis (n = 4), peritumoral abscess (n = 13), 16 patients (76%) required additional treatment prior the CRT: preventive colostomy (n = 14), antibacterial therapy (n = 5). Grade 3 toxicity was observed in 2 (9,52%) patients and in the study group (p = 1). Postoperative mortality was not registered in both groups. Postoperative grade III and higher complications in the study group were observed in 1 (5,2%) patient and in 3 patients (15,7) in the comtrol group (p = 0.129). 19 patients underwent surgery in each group, R0-resection was achieved in 17 patients in the study group and 19 in the control group. Pathological complete response was registered in 1 (5,2%) patient in the study group and in 4 patients in the control group (21,5%) (p = 0,14). Median progression-free survival was not achieved in both groups. CONCLUSION: the combined treatment of complicated locally advanced and recurrent rectal cancer after appropriate planning and concomitant symptomatic therapy does not increase the toxicity profile and postoperative complications rate.

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