Objective: The aim of this study was to evaluate the effect of the interval between CRT and surgery on radiation proctitis, the pathologic response, and postoperative morbidity.
Methods: This was a cohort study from a phase III, randomized controlled trial (FOWARC study, NCT01211210). Data were retrieved from the leading center of the trial. Patients were divided into the short-interval (≤7 weeks) group and the long-interval (>7 weeks) group. The rate of radiation proctitis, pathologic complete regression (pCR) and morbidities were calculated for each group. Multivariate analysis was used to verify the impact of interval on radiation proctitis.
Results: Surgery was performed in 60 patients after an interval of ≤7 weeks and in 97 patients after an interval of >7 weeks. The two groups according to interval were comparable in terms of baseline demographic and clinicotherapeutic characteristics. Radiation proctitis was identified by imaging in 9 (15.0%) patients in short-interval group and in 31 (32.0%) patients in long-interval group (P = .018). Multivariate analysis confirmed the correlation between long interval and radiation proctitis (P = .018). The long interval was significantly associated with longer median operation time compared to the short interval (P = .022). The rates of pCR and postoperative complications were not different between two groups.
Conclusions: A longer interval after CRT may be associated with higher rate of radiation proctitis and longer operation time. Moreover it did not increase the rate of pCR.
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http://dx.doi.org/10.1002/cam4.2755 | DOI Listing |
J Contemp Brachytherapy
June 2024
Department of Radiation Oncology, Keimyung University, Dongsan Hospital, Dalgubeol-daero, Daegu, South Korea.
Purpose: This retrospective study aimed to investigate the influence of bladder filling type (BFT) on the relationship between bladder volume (BV) and maximum absorbed dose (D) in intra-cavitary brachytherapy (ICBT) for cervical cancer.
Material And Methods: The study enrolled 269 patients who underwent 3D-optimized ICBT guided by MRI scans between 2016 and 2022. Bladder shape (categorized as tilted, curved, or E) was determined based on specific applicators used.
ACG Case Rep J
November 2024
Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ.
Severe rectal bleeding is a rare complication of chronic radiation proctitis (CRP). Given CRP's propensity to involve the full thickness of the rectal tissue, we proposed that endoscopic full-thickness resection may be a successful therapeutic modality for treating CRP. A 76-year-old man with multiple comorbid conditions who was not a surgical candidate presented with severe bleeding secondary to CRP that was refractory to all medical and therapeutic interventions.
View Article and Find Full Text PDFStem Cell Res Ther
November 2024
Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, FMBA of Russia, Moscow, Russia, 115682.
Background: Standard approaches to the treatment of chronic post-radiation proctitis are associated with a high risk of complications and a high percentage of unsatisfactory results due to the reduced regenerative potential of irradiated tissues. Regenerative surgery techniques using the stromal-vascular cell fraction (SVF) based on the patient's autologous adipose tissue are a promising direction for study.
Clinical Case Description: A 76-year-old patient suffering from chronic post-radiation erosive-ulcerative proctitis, grade 4 according to RTOG-EORTC, complicated by recurrent profuse rectal bleeding, underwent local autotransplantation of SVF into the submucosal layer of the rectum and pararectal connective tissue.
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