A. Dobrodeev, A. Tarasova, S. G. Afanasiev, D. Kostromitsky, A. A. Ponomareva, N. Babyshkina
{"title":"包括术前化疗在内的上部直肠癌多模式治疗效果","authors":"A. Dobrodeev, A. Tarasova, S. G. Afanasiev, D. Kostromitsky, A. A. Ponomareva, N. Babyshkina","doi":"10.33878/2073-7556-2023-22-4-45-52","DOIUrl":null,"url":null,"abstract":"Aim: to analyze outcomes of multimodal treatment including preoperative chemotherapy with FOLFOX 4 regimen in patients with upper rectal cancer.Patients and Methods: the pilot study included 24 patients. Stages II and III were confirmed in 2 (8.3%) and 22 (91.7%) patients, respectively. All patients underwent 3 cycles of chemotherapy in FOLFOX 4 regimen followed by surgery. In the postoperative period, patients with T4 and N+ underwent adjuvant chemotherapy administered over 6 months including the time of preoperative treatment.Results: all patients completed preoperative chemotherapy with the FOLFOX 4 regimen. The toxicity of chemotherapy was 38.9%; adverse events did not exceed grades I-II. Partial tumor regression (RECIST 1.1 criteria) was achieved in 18 (75.0%) patients. All patients underwent surgery 4 weeks after chemotherapy. Postoperative complications occurred in 4 (16.7%) patients, 1 (4.2%) had grade IIIb complication (Clavien-Dindo scale), which required re-surgery. Pathological complete response (TRG1 by Mandard scale) was revealed in 1 (4.2%) patient. Thirteen patients (54.2%) received adjuvant chemotherapy. The mean follow-up was 38 (17-54) months. Three patients (12.5%) developed local recurrence and 4 (16.7%) patients — distant metastases. The 3-year overall and diseasefree survival rates were 91.7% и 79.2%, respectively.Conclusion: multimodal treatment including preoperative chemotherapy with the FOLFOX 4 regimen was well tolerated and produced tumor regression with high 3-year survival rates in patients with upper rectal cancer.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"31 6","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outcomes of multimodal treatment including preoperative chemotherapy for upper rectal cancer\",\"authors\":\"A. Dobrodeev, A. Tarasova, S. G. Afanasiev, D. Kostromitsky, A. A. Ponomareva, N. Babyshkina\",\"doi\":\"10.33878/2073-7556-2023-22-4-45-52\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Aim: to analyze outcomes of multimodal treatment including preoperative chemotherapy with FOLFOX 4 regimen in patients with upper rectal cancer.Patients and Methods: the pilot study included 24 patients. Stages II and III were confirmed in 2 (8.3%) and 22 (91.7%) patients, respectively. All patients underwent 3 cycles of chemotherapy in FOLFOX 4 regimen followed by surgery. In the postoperative period, patients with T4 and N+ underwent adjuvant chemotherapy administered over 6 months including the time of preoperative treatment.Results: all patients completed preoperative chemotherapy with the FOLFOX 4 regimen. The toxicity of chemotherapy was 38.9%; adverse events did not exceed grades I-II. Partial tumor regression (RECIST 1.1 criteria) was achieved in 18 (75.0%) patients. All patients underwent surgery 4 weeks after chemotherapy. Postoperative complications occurred in 4 (16.7%) patients, 1 (4.2%) had grade IIIb complication (Clavien-Dindo scale), which required re-surgery. Pathological complete response (TRG1 by Mandard scale) was revealed in 1 (4.2%) patient. Thirteen patients (54.2%) received adjuvant chemotherapy. The mean follow-up was 38 (17-54) months. Three patients (12.5%) developed local recurrence and 4 (16.7%) patients — distant metastases. The 3-year overall and diseasefree survival rates were 91.7% и 79.2%, respectively.Conclusion: multimodal treatment including preoperative chemotherapy with the FOLFOX 4 regimen was well tolerated and produced tumor regression with high 3-year survival rates in patients with upper rectal cancer.\",\"PeriodicalId\":17840,\"journal\":{\"name\":\"Koloproktologia\",\"volume\":\"31 6\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-12-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Koloproktologia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.33878/2073-7556-2023-22-4-45-52\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Koloproktologia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.33878/2073-7556-2023-22-4-45-52","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Outcomes of multimodal treatment including preoperative chemotherapy for upper rectal cancer
Aim: to analyze outcomes of multimodal treatment including preoperative chemotherapy with FOLFOX 4 regimen in patients with upper rectal cancer.Patients and Methods: the pilot study included 24 patients. Stages II and III were confirmed in 2 (8.3%) and 22 (91.7%) patients, respectively. All patients underwent 3 cycles of chemotherapy in FOLFOX 4 regimen followed by surgery. In the postoperative period, patients with T4 and N+ underwent adjuvant chemotherapy administered over 6 months including the time of preoperative treatment.Results: all patients completed preoperative chemotherapy with the FOLFOX 4 regimen. The toxicity of chemotherapy was 38.9%; adverse events did not exceed grades I-II. Partial tumor regression (RECIST 1.1 criteria) was achieved in 18 (75.0%) patients. All patients underwent surgery 4 weeks after chemotherapy. Postoperative complications occurred in 4 (16.7%) patients, 1 (4.2%) had grade IIIb complication (Clavien-Dindo scale), which required re-surgery. Pathological complete response (TRG1 by Mandard scale) was revealed in 1 (4.2%) patient. Thirteen patients (54.2%) received adjuvant chemotherapy. The mean follow-up was 38 (17-54) months. Three patients (12.5%) developed local recurrence and 4 (16.7%) patients — distant metastases. The 3-year overall and diseasefree survival rates were 91.7% и 79.2%, respectively.Conclusion: multimodal treatment including preoperative chemotherapy with the FOLFOX 4 regimen was well tolerated and produced tumor regression with high 3-year survival rates in patients with upper rectal cancer.