praeoperative Strahlentherapie des Rektumkarzinoms
Studien
| Studie | Quelle | Tumor | Follow-up | Patenten | RT-Fraktionierung S = 5x5Gy L = normal fraktioniert |
Chemo prae-OP | % 3°-NW preOP | RT - OP | % pCR | Chemo postOP | Ergebnis |
| TROG 01.04 | Ngan et al. (12) | T3 Nx | 5,9a | 163 | S | keine | Lower for S group | 1 W | 1 | 6 M FU/FS | Keine Differenz der primären Endpunkte |
| 163 | L | keine | 4-6 W post RT | 15 | 4 M FU/FS | ||||||
| Polish I | Bujko et al. (13) | T3-4 | 2,9a | 155 | S | keine | 3,2 | 1 W | 0.7 | 6 M FU/FS | Keine Differenz |
| 157 | L | keine | 18,2 | 4-6 W post RT | 16,1 | 4 M FU/FS | |||||
| Latkauskas et al. (8) | T3-T4 N+ | 3,3 a | 68 | S | keine | NS | 6-8 W | 4,4 | 4 M FU/FS | Keine Differenz | |
| 72 | L | keine | post Therapie | 11,1 | |||||||
| STELLAR | Jin et al.(9) | T3-T4 N+ | NS | 238 total | S | 3 M (4 x CAPOX) | 20 | 6-8 W | 18,6 | 1,5 M (2x CAPOX) | NS |
| L | keine | 4,7 | post Therapie | 5,4 | 4,5 M (6 x CAPOX) | ||||||
| Polish II | Cisel et al. (10, 11) | cT4; fixiert T3 | 7,0 a | 261 | S | 1,5 M (3xFOLFOX) | 23 | 12,4 W nach RT-Beginn für jede Gruppe | 16 | keine | Keine Differenz |
| 254 | L | keine | 21 | 12 | |||||||
| RAPIDO | Van der Valk
et al.
ASCO Update (6, 7) |
cT4a/b
cN2 MRF + lateral N + |
NS | 460 | S | 4,5 M (9 x FOLFOX /6 x CAPOX) | 48 | 22-24 W nach RT-Beginn; 2-4 W nach Chemo | 27,7 | keine | Weniger Fernmetastasen |
| 441 | L | keine | 25 | 8 W nach RT-Ende | 13,8 | 6 M (12 xFOLFOX 8 x CAPOX |
Studien
| Studie | 5a-RFS | 5a-OS |
| Dutch TME trial (2) | 94,6 | 64,2 |
| MRC CR07(3) | 95,3 | 70,3 |
| Buiko 2006 (4) | 91 | 67,2 |
| Ngan 2010 (5) | 92,5 | 74 |
| Würzburg 1999-2008 | 91 | 69 |
Adenocarcinoma of the rectum treated by radical external radiation therapy.
IJROBP 31(1995):255-259
2.) Gijn W van, Marijnen CA, Nagtegaal ID et al.:
Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial.
Lancet Oncol 2011;12:575–582
3.) Sebag-Montefiore D, Stephens RJ, Steele R et al.:
Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial.
Lancet 2009;373:811–820
4.) Bujko K, Nowacki MP, Nasierowska-Guttmejer A et al.:
(2006) Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer.
Br J Surg 2006;93:1215–1223
5.) Ngan S, Fisher R, Goldstein D et al.:
(2010) A randomized trial comparing local recurrence (LR) rates between short-course (SC) and long-course (LC) preoperative radiotherapy (RT) for clinical T3 rectal cancer: an intergroup trial (TROG, AGITG, CSSANZ, RACS).
ASCO Annual Meeting 2010
6.) van der Valk MJM, Marijnen CAM, van Etten B, et al.:
Compliance and tolerability of short-course radiotherapy followed by preopera- tive chemotherapy and surgery for high-risk rectal cancer - Results of the international randomized RAPIDO-trial.
Radiother Oncol 2020;147:75-83.
7.) Hospers GAP, Bahadoer RR, Dijkstra EA.:
Short-course radiotherapy followed by chemotherapy before TME in locally advanced rectal cancer: The randomized RAPIDO trial.
J Clin Oncol 2020;38:4006.
8.) Latkauskas T, Pauzas H, Kairevice L, et al.:
Preoperative conventional chemoradiotherapy versus short-course radiotherapy with delayed surgery for rectal cancer: Results of a randomized controlled trial.
BMC Cancer 2016;16:927.
9.) Jin J, Liu S, Zhu Y.:
The updated results for the phase 3 study of 5 x 5 Gy followed by chemotherapy in locally advanced rectal cancer (STELLAR trial).
Int J Radiat Oncol Biol Phys 2017;99:E157.
10.) Cisel B, Pietrzak L, Michalski W, et al.:
Long-course preoperative chemoradiation versus 5 x 5 Gy and consolidation chemotherapy for clinical T4 and fixed clinical T3 rectal cancer: Long-term results of the randomized Polish II study.
Ann Oncol 2019;30:1298-1303.
11.) Bujko K, Wyrwicz L, Rutkowski A, et al.:
Long-course oxaliplatin-based preoperative chemoradiation versus 5 x 5 Gy and consolidation chemotherapy for cT4 or fixed cT3 rectal cancer: Results of a randomized phase III study.
Ann Oncol 2016;27:834-842.
12.) Ngan SY, Burmeister B, Fisher RJ, et al.:
Randomized trial of short-course radiotherapy versus long-course chemoradiation comparing rates of local recurrence in patients with T3 rectal cancer: Trans- Tasman Radiation Oncology Group trial 01.04.
J Clin Oncol 2012;30:3827-3833.
13.) Bujko K, Nowacki MP, Nasierowska-Guttmejer A, et al.:
Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemo- radiation for rectal cancer.
Br J Surg 2006;93:1215-1223.36.
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