Adjuvant preoperative radiotherapy of patients with primary rectal carcinoma improves local control and survival, but also may increase the risk of early postoperative morbidity and mortality.
In addition, the possible late adverse effects of this treatment are largely unknown.
The present study was based on 1027 curatively operated patients included in 2 prospective randomized trials of preoperative radiotherapy for rectal carcinoma patients (Stockholm I and Stockholm II Trials).
The goal was to assess whether long term intercurrent morbidity and mortality were increased in patients allocated to the preoperative treatment.
A computerized linkage of the randomized patients to a population-based registry of the Stockholm County Council was used to study hospital admissions for six groups of a priori defined diseases, putatively related to late adverse effects of the radiation.
Preoperative radiotherapy significantly increased the incidence ofvenous thromboembolism (P=0.01), femoral neck and pelvic fractures (P=0.03), intestinal obstruction (P=0.02), and postoperative fistulas (P=0.01).
For arterial disease and genitourinary tract diseases, no difference in risk was found between irradiated and non irradiated patients.
Radiotherapy significantly reduced rectal carcinoma deaths in both trials and also improved overall survival in the Stockholm II trial.
The late intercurrent mortality was similar in irradiated and nonirradiated patients. (...)
Mots-clés Pascal : Carcinome, Rectum, Homme, Efficacité traitement, Complication, Essai clinique, Radiothérapie, Dose forte, Traitement adjuvant, Préopératoire, Long terme, Epidémiologie, Tumeur maligne, Appareil digestif pathologie, Intestin pathologie, Rectum pathologie
Mots-clés Pascal anglais : Carcinoma, Rectum, Human, Treatment efficiency, Complication, Clinical trial, Radiotherapy, High dose, Adjuvant treatment, Preoperative, Long term, Epidemiology, Malignant tumor, Digestive diseases, Intestinal disease, Rectal disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0427752
Code Inist : 002B13B01. Création : 10/04/1997.