Pre-operative irradiation at rectum cancer gives less chances of relapse but carries more side effects including incontinence and impotence less meaning in sex and pressure.
26 http://link.reuters.com/tek98m July 2010: SOURCE:
J Clin Oncol 2010.
Irradiation-radiotherapy prior to surgery at rectumkankier gives less risk of a relapse. After 3 years showed off a study (The Medical CR07 Research Council/National Cancer Institute or Canada Clinical Trials Group (NCIC CTG CR07 MRC/C016) C016) at 1350 patients with operable rectal rectum cancer that only 4.4% after 3 years in advance from the group that was to have developed a local relapse irradiated also. From the group that was only operated, so without irradiation pre-proved 10.6% have received a local relapse.
Though came from the study show that side effects such as sexual disfuntioneren for the men from the study after the treatment significantly more for came in the group who is irradiated in advance. There was a significant increase in the male sexual dysfunction after surgery (p < 0.001), regardless of the treatment. V but from six months had men who had received significantly larger dysfunction preoperative radiotherapy (p = 0.004). This difference continued throughout at least 2 years.
Very few women answered the sexual dysfunction questions, so the researchers no hard conclusions about the sexual dysfunction for women could draw.
Also in the group that showed greater advance irradiated incontinence was: (53.2% vs 37.3%, p = 0.007).
The researchers recommend that oncologists to individually per patient to weigh or prior irradiation is really needed.
Http://link.reuters.com/tek98m SOURCE:
J Clin Oncol 2010.
Gastrointestinal Cancer
Impact or Short-Course Rectal Cancer on Patients ' Preoperative Radiotherapie for Quality of Life: Data From the Medical Research Council/National Cancer Institute of Canada Clinical Trials CR07 Group C016 Randomized Clinical Trial
Richard J. Stephens, Lindsay C. Thompson, Phil Quirke, Robert Steele, Robert Grieve, Jean Couture, Gareth O. Griffiths, David Sebag-Montefiore
From the Medical Research Council Clinical Trials Unit, London; Leeds Institute of Molecular Medicine and St. James's University Hospital, Leeds; Ninewells Hospital and Medical School, Dundee; Walsgrave Hospital, Coventry; Wales Cancer Trials Unit or Cardiff University, Cardiff, United Kingdom; and Hospital Hotel-Dieu the Levis, Quebec City, Quebec, Canada.
Corresponding author: Lindsay c. Thompson, MSc, BSc, Medical Research Council Clinical Trials Unit, 222 Euston Rd, London, NW1 2DA, United Kingdom; lt@ctu.mrc.ac.uk e-mail:.
ABSTRACT
Purpose The Medical CR07 Research Council/National Cancer Institute or Canada Clinical Trials Group (NCIC CTG CR07 MRC/C016) C016 trial showed that, in patients with operable rectal cancer, short-course preoperative radiotherapie (PRE) reduced the rate of local recurrence compared with surgery followed by selective positive postoperative chemoradiotherapy for patients with a circumferential resection margin. However, the advantages of giving PRE to all patients needs to be balanced against any negative impact on patients ' quality of life.
Patients and Methods All 1,350 patients were asked to complete the Medical Outcomes Study Short-Form 36-item (MOS SF-36) and the European Organisation for Research and Treatment of Colorectal Cancer Quality of Life Questionnaire (EORTC QLQ-CR38) item 38-b. A priori hypotheses related to the impact or treatment on sexual, bowel, and physical function and general health.
Results Male sexual dysfunction was significantly increased following (P ≪. 001) surgery, although there was no difference between treatment arms. However, a treatment difference had emerged at 6 months ( PRE patients reporting significantly greater dysfunction;P =. 004), which persisted out to at least 2 years ( an insufficient number of female patients completed the sexual dysfunction questions to draw firm conclusions). Both treatment groups reported similar levels or decreased physical function at 3 months, but thereafter it returned to baseline levels. There was no evidence of any major changes between treatments or time points in terms of general health or bowel function, but exploratory analysis indicated a significant (P =. 006 at 2 years) increase in the level of fecal incontinence with PRE.
Conclusion These results from a large randomized trial using validated patient-completed show b , that for males, the main adverse effect was sexual dysfunction, and the main cause of this was surgery, but PRE that also affected sexual and some aspects of bowel functioning.
