+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Toxicity and complications of preoperative chemoradiotherapy for locally advanced rectal cancer

, : Toxicity and complications of preoperative chemoradiotherapy for locally advanced rectal cancer. British Journal of Surgery 98(3): 418-426

Capecitabine is an attractive radiosensitizer. In this study acute toxicity and surgical complications were evaluated in patients with locally advanced rectal cancer following total mesorectal excision (TME) after preoperative chemoradiotherapy (CRT) with capecitabine. Between 2004 and 2008, consecutive patients with clinical tumour category (cT) 3-4 (with a threatened circumferential resection margin or cT3 within 5 cm of the anal verge) or clinical node category 2 rectal cancer were treated with preoperative CRT (25 × 2 Gy, capecitabine 825 mg/m(2) twice daily, days 1-33). TME followed 6 weeks later. Toxicity was scored according to the Common Terminology Criteria (version 3.0) and Radiation Therapy Oncology Group scoring systems. Treatment-related surgical complications were evaluated for up to 30 days after discharge from hospital using the modified Clavien-Dindo classification. Some 147 patients were analysed. The mean cumulative dose of capecitabine was 95 per cent and 98·0 per cent of patients received at least 45 Gy. One patient died from sepsis following haematological toxicity. Grade 3-5 toxicity developed in 32 patients (21·8 per cent), especially diarrhoea (10·2 per cent) and radiation dermatitis (11·6 per cent). There were no deaths within 30 days after surgery. Anastomotic leakage and perineal wound complications developed after 13 of 47 low anterior resections and 23 of 62 abdominoperineal resections. Surgical reintervention was required in 30 patients. Twenty-seven patients (19·6 per cent) of 138 patients who had a laparotomy were readmitted within 30 days after initial hospital discharge. Preoperative CRT with capecitabine is associated with acceptable acute toxicity, significant surgical morbidity but minimal postoperative mortality.


PMID: 21254020

DOI: 10.1002/bjs.7315

Other references

Ary, K.R.; Turnbo, M., 1979: Freiberg's infraction: an osteochondritis of the metatarsal head. Journal of the American Podiatry Association 69(2): 131-132

Kurenkov, D.V.; Budarkov, V.A.; Goncharenko, E.N., 2009: The efficiency of ferrocin application in rats at strong stressor exposures. The influence of ferrocine to transfer of the 137Cs from gastrointestinal tract to organs and tissues of rats in conditions of strong stressor exposures was investigated. It is established that mechanical, cold and locomotor exposures reduce the f...

Greenberger, P.A., 2012: Chapter 30: Drug allergy. Drug allergy describes clinical adverse reactions that are proved or presumed to be immunologically based. Allergic drug reactions do not resemble pharmacologic actions of the incriminated drug and may occur at fractions of what would be the thera...

Fan, X.; Chen, J.J., 2004: Regulation of cell cycle progression and apoptosis by the papillomavirus E6 oncogene. Infection with human papillomaviruses (HPV) is strongly associated with the development of cervical cancer. The HPV E6 gene is essential for the oncogenic potential of HPV. E6 abrogates multiple cell cycle checkpoints and modulates apoptosis. Loss...

Kadri M.; Schleiffer J.J.; Adloff J.P., 1991: Speciation of uranium 239 and neptunium 238 produced by radiative neutron capture. Various simple and ccomplex compounds of 238U and 237Np have been irradiated in a neutron flux. The chemical state of 239U and 238Np formed in (n,.gamma.) reactions has been determined as a function of the initial oxidation state of the actinide e...

Pasini, J.; Bubić-Filipi, L., 2000: Kaposi's sarcoma after renal transplantation. Case reports. Immunodeficiency in transplant recipients with chronic immunosuppressive treatment may have influence to developing of virus infection diseases. This publication shows a case report kidney transplant recipient which develops Kaposi's Sarcoma...

Anonymous, 1960: Administrative Report of the Affairs of the Cocoa Board for the Year 1958. Mainly an administrative report. Appendix 14 (pp. 29-35) records the results of variety, manurial and spraying trials (nutritional and disease control), observations on shade tree species and fermentation and drying trials.

Shargal, M.; Moav, R., 1967: Cvtological analysis of mutant albino seedlings in Nicotiana tabacum. Of several thousand N. tabacum seedlings, all heterozygous for the recessive allele ws which in the homozygous condition inhibits chlorophyll production, one is an albino mutant Ten of 32 albino seedlings were found to be haploids of which 4 were...

Kuennemann H.; Precht H., 1979: The influence of environmental temperature and salinity on animals part 1 poikilothermic animals and the normal range of temperature. Within the normal range of temperature several experimental conditions of temperature are considered: single or rhythmic changes of temperature at different dimensions and velocities. These conditions may result in different reactions of the anima...

Fox, J.L., 2001: US deliberates on embryonic stem cells, cloning. Nature Biotechnology 19(9): 791-791