Postoperatif radyoterapi ile eş zamanlı kapesitabin uygulanan lokal ileri evre rektum kanserli olgularda etkinlik (lokal kontrol ve sağkalım) ve toksisitenin değerlendirilmesi
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Date
2008
Authors
Aygün, Sevilcan
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Bu çalışmanın amacı postoperatif radyoterapi (RT) ile eşzamanlı
kapesitabin uygulanmasının lokal ileri evre rektum kanserli olgularda etkinliğini
ve tolere edilebilirliğini değerlendirmektir.
Mart 2004-Ocak 2007 yılları arasında Uludağ Üniversitesi Tıp Fakültesi
Muammer Ağım Radyoterapi Merkezi’nde kapesitabin içeren postoperatif
kemoradyoterapi uygulanan evre II-III rektum adenokarsinomlu 26 olgunun
sonuçları retrospektif olarak değerlendirildi. Olguların ortanca yaşı 58 (sınırlar:
30-83) bulundu. Olguların sekizi (%34) kadın, 18’i (%66) erkekti. RT primer
tümör ve bölgesel lenf nodlarını içerecek şekilde 45 Gy uygulanmıştı ve primer
tümör yatağına 5.4-9 Gray (Gy) boost dozu ile 50.4-54 Gy’e çıkılmıştı. Tüm
olgulara RT süresince oral olarak ortanca 1650 mg/m²/gün (sınırlar: 1300-1650)
dozunda günde iki sefer hafta içi beş gün kapesitabin uygulanmıştı.
Sağkalımı etkileyen prognostik faktörler tek değişkenli analizlerle
değerlendirildi ve p değerinin ≤ 0. 05 olması istatistiksel olarak anlamlı kabul
edildi.
Ortanca iki yıllık GSK oranı %80 idi. Ortanca 19 aylık (sınırlar: 1-30) izlem
süresince hiçbir olguda lokal nüks görülmedi. Müsinöz komponent varlığının
GSK süresine ters olarak anlamlı etki ettiği gözlendi (p: 0, 002). Hastalık evresi
ve nodal evrenin GSK üzerine sınırda anlamlı etkisi mevcuttu (p=0, 051). Grade
3 lökopeni ve diyare sırasıyla bir (%4) ve 2 (%8. 3) olguda gözlendi.
izlem süresi ve olgu sayısı yeterli olmamasına rağmen lokal ileri evre
rektum kanseri tedavisinde eşzamanlı kapesitabin kemoradyoterapisi
uygulanımının etkin ve tolere edilebilir bir tedavi modalitesi olduğu sonucuna
varılmıştır.
The aim of the study was to investigate the efficacy and the tolerability of concomitant overall chemoradiotherapy (CRT) with capecitabine in cases with locally advanced rectal cancer. 26 cases with stage II-III rectal adenocarcinoma, who were treated with postoperative CRT with capecitabine at the Uludag University Faculty of Medicine (Muammer Agim Radiotherapy Center), between March 2004- January 2007, were evaluated retrospectively. Median age of the cases was 58 years (range, 30-83). Eight (34%) and 18 (66 %) of the cases were female and male, respectively. The median irradiation dose given to the primary tumor and regional lymphatics was 45 Gy followed by a boost dose of 5, 4-9 Gy to the primary tumor, bringing to a total doses of 50.4-54 Gy. All cases received oral capecitabine median 1650 mg/m²/day (range, 1300-1650) five days a week during radiotherapy. The prognostic factors effecting survival were analysed by univariate analysis. A p value of 0, 05 ≥ value was considered as statistically significant. The median 2- year overall survival (OS) was 80%, respectively. During the median follow-up time of 19 months (range, 1-30) there was no locoregional recurrence. It was observed that the presence of musinous component inversely impacted OS time (p: 0. 002). Disease stage and nodal stage had borderline iv significance on OS (p: 0. 051). Grade 3 leucopenia and diarrhea were observed in one (4%) and two (8%) cases, respectively. Although the follow-up time and the number of cases were not sufficent, we concluded that the concomitant postoperative chemoradiotherapy with capecitabine may be an effective and tolerabl treatment modality in locally advanced rectal cancer.
The aim of the study was to investigate the efficacy and the tolerability of concomitant overall chemoradiotherapy (CRT) with capecitabine in cases with locally advanced rectal cancer. 26 cases with stage II-III rectal adenocarcinoma, who were treated with postoperative CRT with capecitabine at the Uludag University Faculty of Medicine (Muammer Agim Radiotherapy Center), between March 2004- January 2007, were evaluated retrospectively. Median age of the cases was 58 years (range, 30-83). Eight (34%) and 18 (66 %) of the cases were female and male, respectively. The median irradiation dose given to the primary tumor and regional lymphatics was 45 Gy followed by a boost dose of 5, 4-9 Gy to the primary tumor, bringing to a total doses of 50.4-54 Gy. All cases received oral capecitabine median 1650 mg/m²/day (range, 1300-1650) five days a week during radiotherapy. The prognostic factors effecting survival were analysed by univariate analysis. A p value of 0, 05 ≥ value was considered as statistically significant. The median 2- year overall survival (OS) was 80%, respectively. During the median follow-up time of 19 months (range, 1-30) there was no locoregional recurrence. It was observed that the presence of musinous component inversely impacted OS time (p: 0. 002). Disease stage and nodal stage had borderline iv significance on OS (p: 0. 051). Grade 3 leucopenia and diarrhea were observed in one (4%) and two (8%) cases, respectively. Although the follow-up time and the number of cases were not sufficent, we concluded that the concomitant postoperative chemoradiotherapy with capecitabine may be an effective and tolerabl treatment modality in locally advanced rectal cancer.
Description
Keywords
Rektum kanseri, Kapesitabin, Radyoterapi, Rectal cancer, Capecitabine, Radiotherapy
Citation
Sevilcan, A. (2018). Postoperatif radyoterapi ile eş zamanlı kapesitabin uygulanan lokal ileri evre rektum kanserli olgularda etkinlik (lokal kontrol ve sağkalım) ve toksisitenin değerlendirilmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.