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11 Cards in this Set
- Front
- Back
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Rectum - when is local excision an option? |
T1 (very few T2), upto 8-10cm, <40% of circumference, mod-well differentiated, no LVI |
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Rectum - adjuvant RT,? |
LVI, close margins, poorly differentiated |
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TME reduces local recurrence to how much? |
<10% |
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Dutch TME?
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Neoadjuvant RT +TME vs TME alone. Preop RT reduced local failure but mostly in T3-4 and/or Node positive and low lying tumors |
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Preop RT vs Postop RT |
Preop shown to improve local control, DFS, OS vs surgery lone. Postop vs surgery alone shows only benefit in local control |
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German trial |
Preop chemorad vs postop chemorad (1.8gy, continuos 5FU). Local failure improved 13-->6% with preop. less acute and late toxiciites with preop. no DFS benefit./. Also less APR done. |
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NASBP R03 |
Similar to german, preop chemort to 50.4g only T3-T4 or node positive. DFS improved 53%-->65% with preop. OS only trend. |
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Short-course RT vs long course RT in rectum |
5x5 or 50.4 in 28 fractions. no difference in local control or survival. more early toxicity with long course, more late toxicity (10%) with short course. |
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Chemotherapy for concurrent RT. evidence for which drug? |
only 5FU or xeloda |
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adjuvant chemotherapy ? |
FOLFOX (from colon, no data in rectum) if T3-4 or N+ (consider CRT if not given preop) |
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Meta analysis for preoperative RT vs surgery |
Better 5yos for preop |
