Preoperative versus Postoperative Chemoradiotherapy for Rectal Cancer
This randomized trial compared preoperative with postoperative chemoradiotherapy for locally advanced rectal cancer. Overall survival was similar in the two groups, but patients assigned to preoperative chemoradiotherapy had lower rates of local recurrence and fewer long-term toxic effects than pati...
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| Veröffentlicht in: | The New England journal of medicine 2004-10, Vol.351 (17), p.1731-1740 |
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| creator | Sauer, Rolf Becker, Heinz Hohenberger, Werner Rödel, Claus Wittekind, Christian Fietkau, Rainer Martus, Peter Tschmelitsch, Jörg Hager, Eva Hess, Clemens F Karstens, Johann-H Liersch, Torsten Schmidberger, Heinz Raab, Rudolf |
| description | This randomized trial compared preoperative with postoperative chemoradiotherapy for locally advanced rectal cancer. Overall survival was similar in the two groups, but patients assigned to preoperative chemoradiotherapy had lower rates of local recurrence and fewer long-term toxic effects than patients in the postoperative group.
In this trial of nearly 800 patients, those assigned to preoperative chemoradiotherapy had lower rates of local recurrence and fewer toxic effects.
Adjuvant radiotherapy with or without chemotherapy has been used widely to improve outcomes in patients with rectal cancer. For locally advanced disease, postoperative chemoradiotherapy significantly improves both local control and overall survival as compared with surgery alone or surgery plus irradiation.
1
,
2
This information prompted a National Institutes of Health consensus conference, convened in 1990, to recommend postoperative adjuvant chemoradiotherapy as standard treatment for patients with rectal cancer classified as tumor–node–metastasis (TNM) stage II (i.e., a tumor penetrating the rectal wall, without regional lymph-node involvement) or stage III (i.e., any tumor with regional lymph-node involvement).
3
Several randomized studies have found . . . |
| doi_str_mv | 10.1056/NEJMoa040694 |
| format | Article |
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In this trial of nearly 800 patients, those assigned to preoperative chemoradiotherapy had lower rates of local recurrence and fewer toxic effects.
Adjuvant radiotherapy with or without chemotherapy has been used widely to improve outcomes in patients with rectal cancer. For locally advanced disease, postoperative chemoradiotherapy significantly improves both local control and overall survival as compared with surgery alone or surgery plus irradiation.
1
,
2
This information prompted a National Institutes of Health consensus conference, convened in 1990, to recommend postoperative adjuvant chemoradiotherapy as standard treatment for patients with rectal cancer classified as tumor–node–metastasis (TNM) stage II (i.e., a tumor penetrating the rectal wall, without regional lymph-node involvement) or stage III (i.e., any tumor with regional lymph-node involvement).
3
Several randomized studies have found . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJMoa040694</identifier><identifier>PMID: 15496622</identifier><identifier>CODEN: NEJMAG</identifier><language>eng</language><publisher>Boston, MA: Massachusetts Medical Society</publisher><subject>Adult ; Aged ; Antineoplastic Agents - adverse effects ; Antineoplastic Agents - therapeutic use ; Biological and medical sciences ; Chemotherapy ; Colorectal cancer ; Combined Modality Therapy ; Female ; Fluorouracil - adverse effects ; Fluorouracil - therapeutic use ; Follow-Up Studies ; Gastroenterology. Liver. Pancreas. Abdomen ; General aspects ; Humans ; Incidence ; Male ; Medical sciences ; Medical treatment ; Middle Aged ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Staging ; Postoperative Care ; Postoperative Complications ; Preoperative Care ; Proportional Hazards Models ; Quality Control ; Radiotherapy - adverse effects ; Rectal Neoplasms - drug therapy ; Rectal Neoplasms - mortality ; Rectal Neoplasms - radiotherapy ; Rectal Neoplasms - surgery ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Surgery ; Survival Analysis ; Tumors</subject><ispartof>The New England journal of medicine, 2004-10, Vol.351 (17), p.1731-1740</ispartof><rights>Copyright © 2004 Massachusetts Medical Society. All rights reserved.</rights><rights>2004 INIST-CNRS</rights><rights>Copyright 2004 Massachusetts Medical Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c611t-198ed40493dbe01a533005bcf3b1675ddb50d0ffa662a516a4319a3fceb4e9533</citedby><cites>FETCH-LOGICAL-c611t-198ed40493dbe01a533005bcf3b1675ddb50d0ffa662a516a4319a3fceb4e9533</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.nejm.org/doi/pdf/10.1056/NEJMoa040694$$EPDF$$P50$$Gmms$$H</linktopdf><linktohtml>$$Uhttps://www.nejm.org/doi/full/10.1056/NEJMoa040694$$EHTML$$P50$$Gmms$$H</linktohtml><link.rule.ids>314,776,780,2746,2747,26080,27901,27902,52357,54039</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16200228$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15496622$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sauer, Rolf</creatorcontrib><creatorcontrib>Becker, Heinz</creatorcontrib><creatorcontrib>Hohenberger, Werner</creatorcontrib><creatorcontrib>Rödel, Claus</creatorcontrib><creatorcontrib>Wittekind, Christian</creatorcontrib><creatorcontrib>Fietkau, Rainer</creatorcontrib><creatorcontrib>Martus, Peter</creatorcontrib><creatorcontrib>Tschmelitsch, Jörg</creatorcontrib><creatorcontrib>Hager, Eva</creatorcontrib><creatorcontrib>Hess, Clemens F</creatorcontrib><creatorcontrib>Karstens, Johann-H</creatorcontrib><creatorcontrib>Liersch, Torsten</creatorcontrib><creatorcontrib>Schmidberger, Heinz</creatorcontrib><creatorcontrib>Raab, Rudolf</creatorcontrib><creatorcontrib>German Rectal Cancer Study Group</creatorcontrib><title>Preoperative versus Postoperative Chemoradiotherapy for Rectal Cancer</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>This randomized trial compared preoperative with postoperative chemoradiotherapy for locally advanced rectal cancer. Overall survival was similar in the two groups, but patients assigned to preoperative chemoradiotherapy had lower rates of local recurrence and fewer long-term toxic effects than patients in the postoperative group.
In this trial of nearly 800 patients, those assigned to preoperative chemoradiotherapy had lower rates of local recurrence and fewer toxic effects.
Adjuvant radiotherapy with or without chemotherapy has been used widely to improve outcomes in patients with rectal cancer. For locally advanced disease, postoperative chemoradiotherapy significantly improves both local control and overall survival as compared with surgery alone or surgery plus irradiation.
1
,
2
This information prompted a National Institutes of Health consensus conference, convened in 1990, to recommend postoperative adjuvant chemoradiotherapy as standard treatment for patients with rectal cancer classified as tumor–node–metastasis (TNM) stage II (i.e., a tumor penetrating the rectal wall, without regional lymph-node involvement) or stage III (i.e., any tumor with regional lymph-node involvement).
3
Several randomized studies have found . . .</description><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Agents - adverse effects</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Chemotherapy</subject><subject>Colorectal cancer</subject><subject>Combined Modality Therapy</subject><subject>Female</subject><subject>Fluorouracil - adverse effects</subject><subject>Fluorouracil - therapeutic use</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>General aspects</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medical treatment</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Staging</subject><subject>Postoperative Care</subject><subject>Postoperative Complications</subject><subject>Preoperative Care</subject><subject>Proportional Hazards Models</subject><subject>Quality Control</subject><subject>Radiotherapy - adverse effects</subject><subject>Rectal Neoplasms - drug therapy</subject><subject>Rectal Neoplasms - mortality</subject><subject>Rectal Neoplasms - radiotherapy</subject><subject>Rectal Neoplasms - surgery</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Surgery</subject><subject>Survival Analysis</subject><subject>Tumors</subject><issn>0028-4793</issn><issn>1533-4406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpt0M9LwzAUB_AgipvTm2cpojerLz-aLUcp8xdTh-i5pO0L61iXmrSD_fdGVpgHcwl5fHjv5UvIOYVbCom8e5u-vFoNAqQSB2RIE85jEV6HZAjAJrEYKz4gJ94vIRwq1DEZ0EQoKRkbkuncoW3Q6bbaYLRB5zsfza1v98V0gbV1uqxsuwi1ZhsZ66IPLFq9ilK9LtCdkiOjVx7P-ntEvh6mn-lTPHt_fE7vZ3EhKW1jqiZYChCKlzkC1WFVgCQvDM-pHCdlmSdQgjE67KYTKrXgVGluCswFqqBH5HLXt3H2u0PfZkvbuXUYmTHGlQDFWUA3O1Q4671DkzWuqrXbZhSy38iyv5EFftH37PIayz3uMwrgugfaF3plXPhy5fdOspAzmwR3tXN17bM1Luv_5_0A9G1-vw</recordid><startdate>20041021</startdate><enddate>20041021</enddate><creator>Sauer, Rolf</creator><creator>Becker, Heinz</creator><creator>Hohenberger, Werner</creator><creator>Rödel, Claus</creator><creator>Wittekind, Christian</creator><creator>Fietkau, Rainer</creator><creator>Martus, Peter</creator><creator>Tschmelitsch, Jörg</creator><creator>Hager, Eva</creator><creator>Hess, Clemens F</creator><creator>Karstens, Johann-H</creator><creator>Liersch, Torsten</creator><creator>Schmidberger, Heinz</creator><creator>Raab, Rudolf</creator><general>Massachusetts Medical Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TZ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K0Y</scope><scope>LK8</scope><scope>M0R</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope></search><sort><creationdate>20041021</creationdate><title>Preoperative versus Postoperative Chemoradiotherapy for Rectal Cancer</title><author>Sauer, Rolf ; Becker, Heinz ; Hohenberger, Werner ; Rödel, Claus ; Wittekind, Christian ; Fietkau, Rainer ; Martus, Peter ; Tschmelitsch, Jörg ; Hager, Eva ; Hess, Clemens F ; Karstens, Johann-H ; Liersch, Torsten ; Schmidberger, Heinz ; Raab, Rudolf</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c611t-198ed40493dbe01a533005bcf3b1675ddb50d0ffa662a516a4319a3fceb4e9533</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic Agents - adverse effects</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Chemotherapy</topic><topic>Colorectal cancer</topic><topic>Combined Modality Therapy</topic><topic>Female</topic><topic>Fluorouracil - adverse effects</topic><topic>Fluorouracil - therapeutic use</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>General aspects</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medical treatment</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasm Staging</topic><topic>Postoperative Care</topic><topic>Postoperative Complications</topic><topic>Preoperative Care</topic><topic>Proportional Hazards Models</topic><topic>Quality Control</topic><topic>Radiotherapy - adverse effects</topic><topic>Rectal Neoplasms - drug therapy</topic><topic>Rectal Neoplasms - mortality</topic><topic>Rectal Neoplasms - radiotherapy</topic><topic>Rectal Neoplasms - surgery</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. 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Overall survival was similar in the two groups, but patients assigned to preoperative chemoradiotherapy had lower rates of local recurrence and fewer long-term toxic effects than patients in the postoperative group.
In this trial of nearly 800 patients, those assigned to preoperative chemoradiotherapy had lower rates of local recurrence and fewer toxic effects.
Adjuvant radiotherapy with or without chemotherapy has been used widely to improve outcomes in patients with rectal cancer. For locally advanced disease, postoperative chemoradiotherapy significantly improves both local control and overall survival as compared with surgery alone or surgery plus irradiation.
1
,
2
This information prompted a National Institutes of Health consensus conference, convened in 1990, to recommend postoperative adjuvant chemoradiotherapy as standard treatment for patients with rectal cancer classified as tumor–node–metastasis (TNM) stage II (i.e., a tumor penetrating the rectal wall, without regional lymph-node involvement) or stage III (i.e., any tumor with regional lymph-node involvement).
3
Several randomized studies have found . . .</abstract><cop>Boston, MA</cop><pub>Massachusetts Medical Society</pub><pmid>15496622</pmid><doi>10.1056/NEJMoa040694</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0028-4793 |
| ispartof | The New England journal of medicine, 2004-10, Vol.351 (17), p.1731-1740 |
| issn | 0028-4793 1533-4406 |
| language | eng |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; New England Journal of Medicine |
| subjects | Adult Aged Antineoplastic Agents - adverse effects Antineoplastic Agents - therapeutic use Biological and medical sciences Chemotherapy Colorectal cancer Combined Modality Therapy Female Fluorouracil - adverse effects Fluorouracil - therapeutic use Follow-Up Studies Gastroenterology. Liver. Pancreas. Abdomen General aspects Humans Incidence Male Medical sciences Medical treatment Middle Aged Neoplasm Recurrence, Local - epidemiology Neoplasm Staging Postoperative Care Postoperative Complications Preoperative Care Proportional Hazards Models Quality Control Radiotherapy - adverse effects Rectal Neoplasms - drug therapy Rectal Neoplasms - mortality Rectal Neoplasms - radiotherapy Rectal Neoplasms - surgery Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Surgery Survival Analysis Tumors |
| title | Preoperative versus Postoperative Chemoradiotherapy for Rectal Cancer |
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