TẠP CHÍ SỐ 3-TA NĂM 2020

Evaluation of result of surgical treatment for stage III rectal cancer with preoperative chemo-radiotherapy

Hoang Van An, Hoang Manh An, Nguyen Anh Tuan

Tóm tắt

Objectives: To evaluate the result of surgical treatment for stage III rectal cancer (RC) with preoperative chemo-radiotherapy with cappecitabine at 108 Military Central Hospital. Subjects and methods: Descriptive and retrospective study on 73 stage III RC patients eligible for surgery and received preoperative radiotherapy at a dose of 50.4 Gy/28fx for 5.5 weeks together with 825 mg/m2 of capecitabine twice a day in 5 - 7 days a week. These patients underwent surgery 4 to 12 weeks after finishing chemo-radiotherapy. These patients were evaluated for toxicity due to chemo-radiotherapy, clinical response, postoperative histopathoslogical response, anal sphincter conservation ability and postoperative complications. Results: 57 patients (78%) had clinically complete response, including comprehensive response: 6 patients (8.2%). In terms of postoperative anatomy, 37 patients (50.9%) had tumor (T) period reduction response, of which 2 patients (2.7%) had comprehensive response (pT0). All patients tolerated treatment well, no toxicity at level 4 was observed. Proctitis caused by radiation at level 1 - 2 accounted for 27.4% (20 patients) whereas at level 3 accounted for 1.3% (1 patient), radiation-induced dermatitis at level 1 - 2 was present in 22 patients (30.1%), fatigue at level 1 - 2 was found in 13 patients (17.8%), urinary tract inflammation at level 1 occupied 8.2% (6 patients), weight loss was encounted in 7 cases (9.6%). Anal sphincter conservation surgery obtained 84.9% (62 patients). Postoperative complications was detected in 5 cases of leakage (6.8%). Conclusion: Preoperative chemo-therapy with capecitabine for stage III RC has achieved high rate of post-operative period reduction and increase the capability of anal sphincter conservation surgery. * Keywords: Preoperative chemo-radiotherapy; Rectal cancer.

Abstract

Objectives: To evaluate the result of surgical treatment for stage III rectal cancer (RC) with preoperative chemo-radiotherapy with cappecitabine at 108 Military Central Hospital. Subjects and methods: Descriptive and retrospective study on 73 stage III RC patients eligible for surgery and received preoperative radiotherapy at a dose of 50.4 Gy/28fx for 5.5 weeks together with 825 mg/m2 of capecitabine twice a day in 5 - 7 days a week. These patients underwent surgery 4 to 12 weeks after finishing chemo-radiotherapy. These patients were evaluated for toxicity due to chemo-radiotherapy, clinical response, postoperative histopathoslogical response, anal sphincter conservation ability and postoperative complications. Results: 57 patients (78%) had clinically complete response, including comprehensive response: 6 patients (8.2%). In terms of postoperative anatomy, 37 patients (50.9%) had tumor (T) period reduction response, of which 2 patients (2.7%) had comprehensive response (pT0). All patients tolerated treatment well, no toxicity at level 4 was observed. Proctitis caused by radiation at level 1 - 2 accounted for 27.4% (20 patients) whereas at level 3 accounted for 1.3% (1 patient), radiation-induced dermatitis at level 1 - 2 was present in 22 patients (30.1%), fatigue at level 1 - 2 was found in 13 patients (17.8%), urinary tract inflammation at level 1 occupied 8.2% (6 patients), weight loss was encounted in 7 cases (9.6%). Anal sphincter conservation surgery obtained 84.9% (62 patients). Postoperative complications was detected in 5 cases of leakage (6.8%). Conclusion: Preoperative chemo-therapy with capecitabine for stage III RC has achieved high rate of post-operative period reduction and increase the capability of anal sphincter conservation surgery. * Keywords: Preoperative chemo-radiotherapy; Rectal cancer.

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