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ISSN 2073-8137
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Differentiated approach to prolonged neoadjuvant chemoradiation therapy in complex treatment of rectal cancer

[Oncology]
Oleg Kit; Natalya Vasilievna Soldatkina; Inna Novikova; Marina Aleksandrovna Gusareva; N.K. Al-Hajj; Alexander Vladimirovich Snezhko; Mikhail Alexandrovich Averkin;

The study included 60 patients with resectable rectal cancer who underwent a course of prolonged preoperative chemoradiotherapy. DNA cytometry with the proliferation index assessment was performed before, during and after treatment. The results of DNA cytometric tests were used to divide all patients into 2 groups according to the reduction in proliferation levels. In patients with the indicator of 1.5 times and more, the radiation treatment was considered effective and continued to a total focal dose of 50–54 Gr. The biopsy material of the above patients was studied again 4 weeks after the completion of the full course of prolonged radiation therapy in order to determine the optimal time for surgical treatment. Patients with a decrease in the tumor proliferation index of less than 1.5 times stopped receiving radiotherapy. The overall survival rate differed between the studied groups. The differentiated approach to complex treatment of rectal cancer was clinically effective, in particular, the dynamic evaluation of chemoradiotherapy by comparative DNA cytometry of the biopsy material.

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References:
1. Kaprin A. D., Starinskiy V. V, Petrova G. V. Zlokachestvennyye novoobrazovaniya v Rossii v 2016 godu (zabolevayemost’ i smertnost’). M.: MNIOI im. P. A. Gertsena – filial FGBU «NMHC radiologii» MZ RF, 2018 (In Russ.).
2. De Caluwé L., van Nieuwenhove Y., Ceelen W. P. Preoperative chemoradiation versus radiation alone for stage II and III resectable rectal cancer (Review). Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd., 2013.
3. Pommergaard H. C., Gessler B., Burcharth J., Angenete E., Haglind E., Rosenberg J. Preoperative risk factors for anastomotic leakage after resection for colorectal cancer: a systematic review and meta-analysis. Colorectal. Dis. 2014. https://doi/org/10.1111/codi.12618
4. Demidov S. M., Berezin S. A., Demin A. A. Chastota razvitiya polnogo patomorfologicheskogo otveta opukholi i otdalennyye rezul’taty posle kombinirovannogo lecheniya raka sredne- i nizhneampulyarnogo otdelov pryamoy kishki. Onkologicheskaya koloproktologiya. – Oncological coloproctology. 2014;1:26-32. (In Russ.).
5. Kit O. I., Gevorkyan YU. A., Soldatkina N. V., Novikova I. A., Gusareva M. A., Petrov D. S., Dontsov V. A., Kaymakchi D. O., Al’-Khadzh N. K. Patent na izobreteniye № 2639253 Sposob prognozirovaniya effektivnosti prolongirovannoy luchevoy terapii pri rake pryamoy kishki. Byul. № 35 20.12.2017 (In Russ.).
6. Kit O. I., Gevorkyan YU. A., Soldatkina N. V., Novikova I. A., Gusareva M. A., Petrov D. S., Snezhko A. V., Kaymakchi D. O., Al’-Khadzh N. K. Patent na izobreteniye № 2639392 Sposob opredeleniya optimal’nogo sroka vypolneniya operativnogo vmeshatel’stva posle prolongirovannoy luchevoy terapii pri rake pryamoy kishki. Byul. № 36 21.12.2017 (In Russ.).

Keywords: rectal cancer, preoperative chemoradiotherapy, DNA cytometry


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