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SALT
LAKE CITY OCT 28, 2003 (The Cancer Information Network) - It
is estimated that in 2003, more than 130,000 new cases of
colorectal cancer will be diagnosed in the United States.
Surgery is the standard initial treatment for patients
with resectable colorectal cancer.
For patients with locally advanced (stage III) rectal
cancer, a course of combined chemotherapy and radiation is
usually indicated after curative surgery for better disease
control. The
standard regimen used in the United States has been five weeks
of concurrent chemoradiation starting several weeks after the
completion of surgery. However,
a recent study from Germany showed chemoradiation given before
surgery provides better control compared to the same regimen
given post-operatively.
Dr.
R. Sauer and colleagues from University of Erlangen in Germany
studied more than 800 patients with locally advanced rectal
cancer (cancer that extends beyond the muscle layer of the
rectum or to the regional lymph nodes) in their phase III
prospective randomized trial.
Half of the patient population received 5-6 weeks of
combined chemoradiation before surgery, and the other half
received a similar treatment regimen after surgery.
After a median follow-up of 43 months, the researchers
discovered that patients treated with pre-surgical
chemoradiotherapy had lower pelvic recurrence rates.
In addition, patients receiving combined chemotherapy
and radiation treatment before surgery tended to have smaller
tumors during surgery. Thus,
the chance for sphincter preservation (to retain the function
of the anal canal for normal bowel movement) was significantly
improved. There was also a trend towards reduced acute
toxicity and significantly less chronic toxicity at the
surgical site. However, the overall survival and disease-free
survival time for both groups of patients showed no
difference.
The
results of this study were reported at the American Society of
Therapeutic Radiology and Oncology annual meeting in Salt Lake
City on October 21, 2003 as a plenary paper. Dr. Sauer
concluded that the use of combined chemotherapy and radiation
before surgery should be considered as the standard treatment
for patients with locally advanced rectal cancer.
For
more information about Colorectal Cancer, please visit the Colorectal
Cancer Directory of the Cancer
information Network.
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