1. Acute side effects and complications after short-term preoperative radiotherapy combined with total mesorectal excision in primary rectal cancer: Report of a multicenter randomized trial
- Author
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Marijnen, CAM, Kapiteijn, E, van de Velde, CJH, Martijn, H, Steup, WH, Wiggers, T, Kranenbarg, EK, and Leer, JWH
- Subjects
POSTOPERATIVE RADIOTHERAPY ,CARCINOMA ,RADIATION-THERAPY ,NETHERLANDS ,EUROPEAN-ORGANIZATION ,LOW ANTERIOR RESECTION ,LOCAL RECURRENCE ,ADENOCARCINOMA ,TREATMENT-OF-CANCER ,LOW ANASTOMOSIS - Abstract
Purpose: Total mesorectal excision (TME) surgery in the treatment of rectal cancer has been shown to result in a reduction in the number of local recurrences in retrospective studies. Reports on improved local control after preoperative, hypofractionated radiotherapy (RT) have led to the introduction of a prospective randomized multicenter trial, in which the effect of TME surgery with or without preoperative RT were evaluated. Any benefit in regard to a reduced local recurrence rate and possible improved survival must be weighed against potential adverse effects in both the short-term and the long-term. The present study was undertaken to assess the acute side effects of short-term, preoperative RT in rectal cancer patients and to study the influence of five doses of 5 Gy on surgical parameters, postoperative morbidity and mortality in patients randomized in the Dutch TME trial. Patients and Methods: We analyzed 1,530 Dutch patients entered onto a prospective randomized trial, comparing preoperative RT with five doses of 5 Gy followed by TME surgery with TME surgery alone, of which 1,414 patients were assessable. Toxicity from RT, surgery characteristics, and postoperative complications and mortality were compared. Results: Toxicity during RT hardly occurred. Irradiated patients had 100 mL more blood loss during the operation (P
- Published
- 2002