Organ or sphincter preservation for rectal cancer. The role of contact X-ray brachytherapy in a monocentric series of 112 patients.pdfVIP

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Organ or sphincter preservation for rectal cancer. The role of contact X-ray brachytherapy in a monocentric series of 112 patients.pdf

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Organ or sphincter preservation for rectal cancer. The role of contact X-ray brachytherapy in a monocentric series of 112 patients.pdf

European Journal of Cancer 72 (2017) 124e136 Available online at ScienceDirect journal homepage: Original Research Organ or sphincter preservation for rectal cancer. The role of contact X-ray brachytherapy in a monocentric series of 112 patients Anne Claire Frin a, Ludovic Evesque b, Jocelyn Gal c, Kare`ne Benezery d, Eric Franc?ois a, Jean Gugenheim e, Emmanuel Benizri e, Yan Cha?teau c, Serge Marcie′ d, Je′rome Doyen d, Jean-Pierre Ge′rard d,* a CHU Nice, Department of Gastroenterology, Nice Sophia-Antipolis University, France b Centre Antoine Lacassagne, Department of Medical Oncology, Nice Sophia-Antipolis University, France c Centre Antoine Lacassagne, Department of Research and Methodology, Nice Sophia-Antipolis University, France d Centre Antoine Lacassagne, Department of Radiation Oncology, Nice Sophia-Antipolis University, France e CHU Nice, Department of Surgery, Nice Sophia-Antipolis University, France Received 19 September 2016; received in revised form 31 October 2016; accepted 16 November 2016 Available online 24 December 2016 KEYWORDS Rectal cancer; Organ preservation; Conservative treatment; Contact X-ray brachytherapy; Papillon treatment Abstract Background: Contact X-ray brachytherapy (CXB) has been used at Centre Antoine Lacassagne since 2002 to increase the chance of conservative treatment (organ or sphincter preservation) in rectal cancer. A consecutive series of 112 patients (pts) is reported. Methods: Three protocols were used in selected rectal adenocarcinomas. Group 1: T1 N0 treated with local excision (LE) followed by adjuvant CXB. Group 2: T2 or ‘early’ T3 N0 treated with CXB combined with chemoradiotherapy (CRT) followed by surveillance or LE. Group 3: distal ‘locally advanced’ T3 N0-2 treated with CXB and CRT before total proctectomy. Results: Group 1: 27 pt (pTis: 3; pT1: 21; pT2: 3). After LE with CXB alone (20 pt) or CXB t CRT (7 pt) one local recurrence occurred. Organ preservation was achieved in 26 pt (96%). Group 2: 45 pt (T1: 2