The synchronization of chemotherapy to circadian rhythms and irradiation in pre-operative chemoradiation therapy with hyperthermia for local advanced rectal cancer
The synchronization of chemotherapy to circadian rhythms and irradiation in pre-operative chemoradiation therapy with hyperthermia for local advanced rectal cancer
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DOI：
10.1080/02656730600799873
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发表时间：
2006-08-01
影响因子：
3.1
通讯作者：
Kuwano, Hiroyuki
中科院分区：
文献类型：
--
作者：
Asao, Takayuki;Sakurai, Hideyuki;Kuwano, Hiroyuki
目的：评价直肠腺癌患者术前同步放化疗加局部热疗的疗效和不良反应。材料与方法：T2-T4直肠腺癌患者术前全骨盆放疗总剂量为40 Gy （n = 10）或50 Gy (n = 19)，放疗期间热疗每周一次，持续1h。化疗包括5- fu（每天250 mgm(-2)）和LV（每天25mgm(-2)），在放疗的第二和第四周，每周连续输注5天，每晚持续输注。结果：3级以上毒性仅见于2例患者（6.9%）。41.4%的病例和52.6%的放射剂量为50 Gy的病例的分期明显下降。在接受手术切除肿瘤的患者中，3例（11.1%）的标本病理上没有残留，8例（29.6%）有显微镜下的病变。结论：这些结果为晚期低直肠腺癌提供了高反应率和最小毒性。在照射前的睡眠时间给予5-FU可能不仅作为一种时间疗法，而且作为一种辐射增敏剂具有优势。
Purpose: The therapeutic and adverse effects of pre-operative chrono-chemoradiation with local hyperthermia for patients with rectal adenocarcinoma were evaluated.Materials and methods: Pre-operative radiation therapy of a total dose of 40 Gy (n = 10) or 50 Gy ( n 19) on the whole pelvis and hyperthermia once a week during the radiation therapy for 1 h were performed for patients with T2-T4 rectal adenocarcinoma. Chemotherapy consisted of 5-FU (250 mgm(-2) per day) and LV (25mgm(-2) per day) administered by continuous infusion in the night for 5 days a week in the second and fourth weeks of radiation.Results: Grade 3+ toxicities were seen only in two patients (6.9%). A significant down staging was seen in 41.4% of all cases and 52.6% of cases with a radiation dose of 50 Gy. Of the patients who had received surgical resection of a tumour, three (11.1%) had no residue pathologically in the specimen and eight (29.6%) had microscopic lesions.Conclusions: These results yielded a high response rate with minimal toxicities for advanced low-rectal adenocarcinoma. The administration of 5-FU during the sleeping time before irradiation might have an advantage not only as a chronotherapy but also as a radiation sensitizer.