Preoperative radiation

There is currently no definitive role for adjuvant radiation in colon cancer. However, patients who receive surgery for rectal cancer receive radiation therapy to reduce local tumor recurrence. Adjuvant radiation plus chemotherapy is considered standard treatment for patients with stage II or III rectal cancer after the surgical procedure is complete.17 Preoperative radiation may be used to reduce the initial size of rectal cancers in order to make the surgical procedure easier. 

Another unique aspect of rectal cancer is the use of neoadjuvant therapy. Preoperative radiation with or without chemotherapy is given to downstage the tumor prior to surgical resection to improve sphincter preservation by making the surgical procedure easier to perform. The issue of preoperative versus postoperative radiation is a subject of debate and investigation in the United States and will require further data to determine the superiority of one method over the other. 

In this instance the early experience of Nigro et al. (45) suggested that there may not be a need to perform surgery as part of the initial therapy of this cancer and that it could be kept in reserve for local recurrence. Three patients treated with preoperative radiation,... 

Postoperative Radiation Therapy Postoperative Chemotherapy or Chemoradiation NeOADJUVANT THERAPY, In GENERAL Preoperative Radiation Therapy Preoperative Chemotherapy Preoperative Chemoradiation... 

Payne DG. Preoperative radiation therapy in non-small cell carcinoma of the lung. Lung Cancer 1991 7 47-56. 

There have been many valid criticisms of these preoperative radiation studies. These criticisms include the varied dose and fractionation schedules. No two trials have used the same radiation regimen. None of these trials have allowed an adequate interval between completion of radiation and surgery. In general, at least 4-6 wk are required for... 

Hoffman JP, et al. Phase II trial of preoperative radiation therapy and chemotherapy for patients with localized, resectable adenocarcinoma of the pancreas an Eastern Cooperative Oncology Group Study. J Clin Oncol 1998 16(1) 317—323. 

Prospective Trials of Preoperative Radiation Therapy With and Without Chemotherapy and Rate of Sphincter-Sparing Procedures... 

Wagman R, Minsky BD, Cohen AM, et al. Sphincter preservation in rectal cancer with preoperative radiation therapy and coloanal anastomosis long term follow-up. Int JRadiat Oncol Biol Phys 1998 42 51-57. 

Francois Y, Nemoz CJ, Baulieux J, et al. Influence of the interval between preoperative radiation therapy and surgery on downstaging and on the rate of sphincter-sparing surgery for rectal cancer the Lyon R90-01 randomized trial. J Clin Oncol 1999 17(8) 2396-2402. 

Skinner DG, Lieskovsky G. Contemporary cystectomy with pelvic node dissection compared to preoperative radiation therapy plus cystectomy in management of invasive bladder cancer. J Urol 1984 131 1069-1072. 

Ariyan S, Marfaggi RA, Harden G, et al. (1980) An experimental model to determine the effects of adjuvant therapy on the incidence of postoperative wound infection. I. Evaluating Preoperative Radiation Therapy. Plast Reconstr Surg 65328-337... 

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