Successful Downstaging of High Rectal and Recto-Sigmoid Cancer by Neo-Adjuvant Chemo-Radiotherapy
Author Information
Author(s): O’Neill Brian, Brown Gina, Wotherspoon Andrew, Burton Sarah, Norman Andy, Tait Diana
Primary Institution: Mayday University Hospital, Croydon, U.K.
Hypothesis
The study aims to demonstrate the feasibility and downstaging of treating locally advanced tumours from high rectum to distal sigmoid with preoperative chemoradiotherapy.
Conclusion
Pre-operative chemoradiotherapy can effectively treat locally advanced high rectal and recto-sigmoid tumours with acceptable toxicity and impressive down-staging.
Supporting Evidence
- Overall survival was 82.35% and disease-free survival was 81.25%.
- Nine patients (52.9%) were downstaged after treatment.
- Six patients (35.3%) achieved a complete pathological response.
Takeaway
Doctors can shrink big tumors in the rectum and sigmoid area before surgery using special medicine and radiation, which helps them remove the tumors more easily.
Methodology
Seventeen patients received neoadjuvant chemoradiotherapy based on MRI findings indicating T4 disease or threatened circumferential resection margin.
Potential Biases
Potential bias in patient selection and treatment protocols.
Limitations
The study had a small sample size and was not a randomized trial.
Participant Demographics
9 males and 8 females, median age 61 years (range 27–79).
Statistical Information
Confidence Interval
95% CI 54.7–93.9
Statistical Significance
p<0.05
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