Effect of the dose of radiation (RT) to the anal sphincter on the sphincter function of patients with locally advanced rectal cancer (LARC) treated with preoperative chemoradiotherapy followed by low anterior resection (LAR) with total mesorectum excision (TME).

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. e14595-e14595
Author(s):  
Fernando Arias ◽  
Clara Eito ◽  
Itxaso Mora ◽  
Koldo Cambra ◽  
Fernando Mañeru ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anal Sphincter ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Preoperative Chemoradiotherapy ◽  
Locally Advanced Rectal Cancer ◽  
Sphincter Function ◽  
Total Mesorectum Excision

Preoperative chemo-radiotherapy in rectal cancer. Effect on down staging and possibility of sphincter sparing surgery

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 14598-14598
Author(s):  
T. Z. Mohran ◽  
H. A. Rayad
Keyword(s):  
Rectal Cancer ◽  
Abdominoperineal Resection ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Curative Resection ◽  
Performance Status ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Border Line

14598 Objectives: To evaluate the influence of pre-operative chemo-radiation on resectability of locally advanced rectal cancer and the possibility of performing sphincter- sparing surgery in cases not suitable for this procedures. Methods: 30 patients with rectal carcinoma with either border line respectability or not suitable for primary sphincter sparing surgery. Performance status > 60, adequate bone marrow reserve and adequate hepatic and renal functions. All patients had been staged by radiological studies and endoscopies. Treatment: All patients were treated by combined chemo-radiation. Radiotherapy with dose of 45 Gray in 25 fractions over 5 weeks. Chemotherapy with 5-flurouracil 500 mg/m2 I.V infusion over 2 hours and leucovorin immediately before radiation setting for first 5 days of the first week and the first 5 days of the last week of radiation. Patients were evaluated 4–6 weeks after treatment. Operable patients were subjected to abdominoperineal resection (APR) or low anterior resection (AR). Toxicity was evaluated using WHO Common Toxicity Criteria. Results: 30 patients were included; the median age was 48 years. Partial response was reported in 63.4% of patients and stable disease was reported in 33.3% of patients while progressive disease was reported in only one patient. Low anterior resection (AR) had been performed in 8 patients out of 12 (66.2%) who had initially not suitable for primary sphincter preservation, while abdominoperineal resection (APR) had been performed in 11 patients out of 18 patients (61.1%) who had initially border line resectability. Tumor down staging was achieved in 66% of patients. Tumor stage was identified as the only significant prognostic factors in response. Local control rate at 18 months were 85%. Actuarial overall survival for patient with curative resection at 18 months, were 85%. Toxicities included G3 leucopenia in 10% of patients, Diarrhea G3 in 13.3% of patients. Conclusion: Preoperative chemo-radiotherapy is an effective treatment in inducing down-staging of locally advanced rectal cancer patients and enhances curative resection and sphincter preserving procedures. Keyword: Colorectal cancer; Chemo- radiotherapy No significant financial relationships to disclose.

Effects of adjuvant oxaliplatin on anal function in locally advanced rectal cancer treated with preoperative chemoradiotherapy and low anterior resection.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 718-718
Author(s):  
Fernando Arias ◽  
Clara Eito ◽  
Antonio Viudez ◽  
Gemma Asin ◽  
Berta Ibañez ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Adjuvant Treatment ◽  
Anterior Resection ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Anal Function ◽  
Sphincter Function ◽  
Anal Sphincter Function ◽  
Incontinence Score

718 Background: The main purpose of the present study was to determine if the addition of adjuvant oxaliplatin (OXA) could have some influence on sphincter function in patients with locally advanced rectal cancer (LARC) treated with preoperative capecitabine/radiotherapy followed by lower anterior resection (LAR). Methods: Those patients with LARC treated at our center with LAR and without two-years loco-regional relapse were retrospectively analyzed independent of the type of adjuvant treatment received. Anal sphincter function was assessed by Wexner´s incontinence score (0 to 20 points, being punctuation inversely proportional to sphincter function). All questionnaires were completed between January 2010 and December 2012. Comparisons of sphincter function measured with the Wexner test between patients with and without OX were conducted with the Mann-Whitney test. Statistical analyses were conducted using IBM SPSS Statistics, version 20. Results: From 2006, 92 consecutive patients were included in our study. Mean time from LAR to fecal function assessment was 58 months (25 to 96 months). Wexner test median values did not differ significantly (p=0.450) between patients with and without adjuvant OXA. The median (IQR) for the group without adjuvant OXA was 6.0 (1.0-11.25), being for group that received adjuvant OXA of 5.0 (1.0-10.0). Conclusions: Based on our findings, OXA could be used as adjuvant treatment in LARC, due to its absent of deleterious influence over the sphincter anal function. Because of the retrospective nature of our study, prospective studies should be warranted in similar scenarios. This study has been supported by a grant of “Mutua Madrileña Fundation.”

Assessment of bowel and anal sphincter function after neoadjuvant chemoradiotherapy in locally advanced rectal cancer

2018 ◽  
Vol 104 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Consuelo Rosa ◽  
Monica Di Tommaso ◽  
Luciana Caravatta ◽  
Annamaria Vinciguerra ◽  
Antonietta Augurio ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anal Sphincter ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Well Being ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Sphincter Function ◽  
Anal Sphincter Function ◽  
Increased Risk

Purpose: To report long-term effects on anorectal function and bowel disorders and late toxicity rate of preoperative chemoradiotherapy in patients with locally advanced rectal cancer. Methods: Between 2000 and 2016, 201 patients treated with different neoadjuvant schedules of chemotherapy and radiotherapy doses were retrospectively analyzed. The Memorial Sloan–Kettering Cancer Center score was used for the evaluation of anal sphincter function. Results: The median follow-up time was 68 months (interquartile range 35–113 months). Radical resection was performed in 188 (93.5%) patients with a pathologic complete response rate of 26.4%. Overall sphincter function resulted excellent in 105 (52.2%) patients, good in 13 (6.5%), fair in 10 (5.0%), and poor (incontinence) in 40 (19.9%), with a persistent stoma rate of 16.4%. A further evaluation on 194 patients showed an improvement of sphincter function after 2 years in 11.9% of them. Seventy-three patients presenting stoma or poor sphincter function were re-evaluated for quality of life (QoL) indexes. Twenty-one (29%), 19 (26%), and 24 (33%) of them declared some variations concerning well-being, fatigue, and ability to perform daily activities. The 5-year overall survival, disease-free survival, and local recurrence rates were 88.0% ± 2.6%, 86.3% ± 2.5%, and 94.6% ± 1.9%, respectively. Conclusions: In our study, neoadjuvant chemoradiotherapy was associated with good results in terms of sphincter function, late toxicities, and QoL indexes. A routine use of assessment scales could contribute to a better selection of patients with increased risk of developing functional disorders who could benefit from neoadjuvant therapy.

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