Improved local control and survival with the "sandwich" technique of pelvic radiotherapy for resectable rectal cancer - A retrospective, multivariate analysis

Claudio Botti, Maurizio Cosimelli, Fabrizio Ambesi Impiombato, Diana Giannarelli, Valerio Casaldi, Giulia Wappner, Sabrina Consolo, Vincenzo Casale, Renato Cavaliere

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

PURPOSE: The following study was done to evaluate the therapeutic value of radiotherapy as an adjunct to surgery for rectal cancer patients. METHODS: One-hundred twenty-four patients underwent curative resection by one surgeon (RC) from 1982 to 1991. Forty patients received combined preoperative and postoperative (sandwich) radiotherapy, 30 patients received postoperative radiotherapy, and 54 patients were treated by surgery alone. During the study period sandwich radiotherapy was primarily offered as a free treatment option for patients with tumors which were believed to be transmurally invasive, whereas postoperative radiotherapy was an alternative therapeutic option offered to patients with tumor classified as Dukes B and C at histopathologic examination. RESULTS: Operative mortality was 2 percent in the sandwich radiotherapy groupvs.7 percent in the surgery alone group. After a median follow-up of 60 months, the actuarial locoregional recurrence rate at five years was 3 percent for the sandwich radiotherapy group compared with 18 and 30 percent for the postoperative radiotherapy and surgery alone groups, respectively (P=0.019). A multivariate analysis using the Cox model confirmed the favorable independent influence of sandwich radiotherapy on local tumor control, especially in distal tumors. The therapeutic benefit of sandwich radiotherapy translated into increased survival in the low-rectum Dukes B subgroup of patients. The actuarial five-year survival rates were 86 percent, 50 percent, and 28 percent in the sandwich radiotherapy, postoperative radiotherapy and surgery alone groups, respectively (P=0.05). CONCLUSIONS: Preoperative radiotherapy has a significant effect on the prognosis of rectal cancer patients.

Original languageEnglish
JournalDiseases of the Colon and Rectum
Volume37
Issue number2 Supplement
DOIs
Publication statusPublished - Feb 1994

Fingerprint

Rectal Neoplasms
Radiotherapy
Multivariate Analysis
Survival
Neoplasms
Therapeutics
Proportional Hazards Models
Rectum
Survival Rate

Keywords

  • Adjuvant radiotherapy
  • Multivariate analysis
  • Rectal cancer

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Improved local control and survival with the "sandwich" technique of pelvic radiotherapy for resectable rectal cancer - A retrospective, multivariate analysis. / Botti, Claudio; Cosimelli, Maurizio; Impiombato, Fabrizio Ambesi; Giannarelli, Diana; Casaldi, Valerio; Wappner, Giulia; Consolo, Sabrina; Casale, Vincenzo; Cavaliere, Renato.

In: Diseases of the Colon and Rectum, Vol. 37, No. 2 Supplement, 02.1994.

Research output: Contribution to journalArticle

Botti, Claudio ; Cosimelli, Maurizio ; Impiombato, Fabrizio Ambesi ; Giannarelli, Diana ; Casaldi, Valerio ; Wappner, Giulia ; Consolo, Sabrina ; Casale, Vincenzo ; Cavaliere, Renato. / Improved local control and survival with the "sandwich" technique of pelvic radiotherapy for resectable rectal cancer - A retrospective, multivariate analysis. In: Diseases of the Colon and Rectum. 1994 ; Vol. 37, No. 2 Supplement.
@article{280c76e0945a4470a9fdf2ecc55c86e0,
title = "Improved local control and survival with the {"}sandwich{"} technique of pelvic radiotherapy for resectable rectal cancer - A retrospective, multivariate analysis",
abstract = "PURPOSE: The following study was done to evaluate the therapeutic value of radiotherapy as an adjunct to surgery for rectal cancer patients. METHODS: One-hundred twenty-four patients underwent curative resection by one surgeon (RC) from 1982 to 1991. Forty patients received combined preoperative and postoperative (sandwich) radiotherapy, 30 patients received postoperative radiotherapy, and 54 patients were treated by surgery alone. During the study period sandwich radiotherapy was primarily offered as a free treatment option for patients with tumors which were believed to be transmurally invasive, whereas postoperative radiotherapy was an alternative therapeutic option offered to patients with tumor classified as Dukes B and C at histopathologic examination. RESULTS: Operative mortality was 2 percent in the sandwich radiotherapy groupvs.7 percent in the surgery alone group. After a median follow-up of 60 months, the actuarial locoregional recurrence rate at five years was 3 percent for the sandwich radiotherapy group compared with 18 and 30 percent for the postoperative radiotherapy and surgery alone groups, respectively (P=0.019). A multivariate analysis using the Cox model confirmed the favorable independent influence of sandwich radiotherapy on local tumor control, especially in distal tumors. The therapeutic benefit of sandwich radiotherapy translated into increased survival in the low-rectum Dukes B subgroup of patients. The actuarial five-year survival rates were 86 percent, 50 percent, and 28 percent in the sandwich radiotherapy, postoperative radiotherapy and surgery alone groups, respectively (P=0.05). CONCLUSIONS: Preoperative radiotherapy has a significant effect on the prognosis of rectal cancer patients.",
keywords = "Adjuvant radiotherapy, Multivariate analysis, Rectal cancer",
author = "Claudio Botti and Maurizio Cosimelli and Impiombato, {Fabrizio Ambesi} and Diana Giannarelli and Valerio Casaldi and Giulia Wappner and Sabrina Consolo and Vincenzo Casale and Renato Cavaliere",
year = "1994",
month = "2",
doi = "10.1007/BF02048425",
language = "English",
volume = "37",
journal = "Diseases of the Colon and Rectum",
issn = "0012-3706",
publisher = "Lippincott Williams and Wilkins",
number = "2 Supplement",

}

TY - JOUR

T1 - Improved local control and survival with the "sandwich" technique of pelvic radiotherapy for resectable rectal cancer - A retrospective, multivariate analysis

AU - Botti, Claudio

AU - Cosimelli, Maurizio

AU - Impiombato, Fabrizio Ambesi

AU - Giannarelli, Diana

AU - Casaldi, Valerio

AU - Wappner, Giulia

AU - Consolo, Sabrina

AU - Casale, Vincenzo

AU - Cavaliere, Renato

PY - 1994/2

Y1 - 1994/2

N2 - PURPOSE: The following study was done to evaluate the therapeutic value of radiotherapy as an adjunct to surgery for rectal cancer patients. METHODS: One-hundred twenty-four patients underwent curative resection by one surgeon (RC) from 1982 to 1991. Forty patients received combined preoperative and postoperative (sandwich) radiotherapy, 30 patients received postoperative radiotherapy, and 54 patients were treated by surgery alone. During the study period sandwich radiotherapy was primarily offered as a free treatment option for patients with tumors which were believed to be transmurally invasive, whereas postoperative radiotherapy was an alternative therapeutic option offered to patients with tumor classified as Dukes B and C at histopathologic examination. RESULTS: Operative mortality was 2 percent in the sandwich radiotherapy groupvs.7 percent in the surgery alone group. After a median follow-up of 60 months, the actuarial locoregional recurrence rate at five years was 3 percent for the sandwich radiotherapy group compared with 18 and 30 percent for the postoperative radiotherapy and surgery alone groups, respectively (P=0.019). A multivariate analysis using the Cox model confirmed the favorable independent influence of sandwich radiotherapy on local tumor control, especially in distal tumors. The therapeutic benefit of sandwich radiotherapy translated into increased survival in the low-rectum Dukes B subgroup of patients. The actuarial five-year survival rates were 86 percent, 50 percent, and 28 percent in the sandwich radiotherapy, postoperative radiotherapy and surgery alone groups, respectively (P=0.05). CONCLUSIONS: Preoperative radiotherapy has a significant effect on the prognosis of rectal cancer patients.

AB - PURPOSE: The following study was done to evaluate the therapeutic value of radiotherapy as an adjunct to surgery for rectal cancer patients. METHODS: One-hundred twenty-four patients underwent curative resection by one surgeon (RC) from 1982 to 1991. Forty patients received combined preoperative and postoperative (sandwich) radiotherapy, 30 patients received postoperative radiotherapy, and 54 patients were treated by surgery alone. During the study period sandwich radiotherapy was primarily offered as a free treatment option for patients with tumors which were believed to be transmurally invasive, whereas postoperative radiotherapy was an alternative therapeutic option offered to patients with tumor classified as Dukes B and C at histopathologic examination. RESULTS: Operative mortality was 2 percent in the sandwich radiotherapy groupvs.7 percent in the surgery alone group. After a median follow-up of 60 months, the actuarial locoregional recurrence rate at five years was 3 percent for the sandwich radiotherapy group compared with 18 and 30 percent for the postoperative radiotherapy and surgery alone groups, respectively (P=0.019). A multivariate analysis using the Cox model confirmed the favorable independent influence of sandwich radiotherapy on local tumor control, especially in distal tumors. The therapeutic benefit of sandwich radiotherapy translated into increased survival in the low-rectum Dukes B subgroup of patients. The actuarial five-year survival rates were 86 percent, 50 percent, and 28 percent in the sandwich radiotherapy, postoperative radiotherapy and surgery alone groups, respectively (P=0.05). CONCLUSIONS: Preoperative radiotherapy has a significant effect on the prognosis of rectal cancer patients.

KW - Adjuvant radiotherapy

KW - Multivariate analysis

KW - Rectal cancer

UR - http://www.scopus.com/inward/record.url?scp=0028316940&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028316940&partnerID=8YFLogxK

U2 - 10.1007/BF02048425

DO - 10.1007/BF02048425

M3 - Article

VL - 37

JO - Diseases of the Colon and Rectum

JF - Diseases of the Colon and Rectum

SN - 0012-3706

IS - 2 Supplement

ER -