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[Adjuvant radiotherapy in rectosigmoid cancers].

R Winkler

    Zentralblatt Fur Chirurgie
    |January 1, 1985
    PubMed
    Summary

    This study compared different radiotherapy schedules for rectosigmoidal cancer. The combined pre- and postoperative irradiation technique significantly reduced local recurrence rates with good tolerability.

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    Area of Science:

    • Oncology
    • Radiation Oncology
    • Surgical Oncology

    Background:

    • Rectosigmoidal cancer treatment often involves radiotherapy.
    • Optimizing radiotherapy timing and techniques is crucial for improving patient outcomes.
    • Comparing preoperative versus postoperative irradiation strategies is essential.

    Purpose of the Study:

    • To compare the efficacy and safety of different radiotherapy regimens in rectosigmoidal cancer.
    • To evaluate the impact of preoperative irradiation, postoperative irradiation, and a combined approach on local recurrence rates.
    • To assess the tolerability and surgical implications of these radiotherapy strategies.

    Main Methods:

    • A randomized phase-III multicenter clinical trial.
    • Comparison of three arms: (A) postoperative irradiation (50 Gy), (B) preoperative + postoperative irradiation (25 Gy + 25 Gy), and (C) preoperative irradiation alone (25 Gy).
    • High-risk patients (Dukes B, C) received postoperative irradiation; surgery followed preoperative irradiation within 24 hours.

    Main Results:

    • Preoperative irradiation was well-tolerated, without compromising surgery or increasing complications.
    • Radical radiation procedures (A and B) drastically reduced local recurrence rates compared to preoperative irradiation alone (C).
    • Distant metastasis rates were not significantly influenced by any of the procedures.

    Conclusions:

    • The combined pre- and postoperative irradiation (sandwich technique) offers significant benefits in reducing local recurrence for rectosigmoidal cancer.
    • This combined approach demonstrates superior efficacy and acceptable tolerability compared to other regimens.
    • The findings support the use of the sandwich technique for improved outcomes in rectosigmoidal cancer radiotherapy.

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