Nüks Rektum Kanserinde İntraoperatif Radyoterapi

İsmail Ahmet Bilgin; Erman Aytaç; İlknur Erenler Bayraktar; Bilgehan Şahin; Banu Atalar; Nuran Beşe; Enis Özyar; Bilgi Baca; İsmail Hamzaoğlu; Tayfun Karahasanoğlu

EN TR

Intraoperative Radiation Therapy For Recurrent Rectal Cancer

Abstract

Introduction: As one of the multimodal treatment options available in locally advanced or recurrent rectal cancer, intraoperative radiotherapy IORT may be a preferred option to achieve local control. In this study, we aim to report on our experience with those recurrent rectal cancer cases which were treated with radical surgery and intraoperative radiotherapy.Methods: Cases treated with radical surgery and IORT for recurrent rectal cancer between November 2012 and December 2016 at Acibadem Mehmet Ali Aydinlar University Medical Faculty Hospital, Maslak, Istanbul, were included in this study.Results: 8 patients 4 male, 4 female with recurrent rectal cancer were included in this study. All the patients had recurrent adenocarcinoma. The median age was 54.5 and median BMI was 34.3 range 19.6-32.5 kg/m2. In all cases, the previous surgery undertaken was sphincter-preserving resection. For recurrent tumors, low anterior resection was performed on 4 patients, abdominoperineal resection was performed on 2 patients and pelvic exenteration was performed on 2 patients. R0 resection was observed in 5, R1 in 2, and R2 in 1 patient. At short-term follow-up, infection had developed at the operative site in 2 patients. The median hospital stay was 8 days. During the median follow-up period of 36 months, 4 patients were observed to be disease-free, 2 patients had pelvic recurrence and 2 patients died.Conclusion: IORT increases the effectiveness of surgery for local control in recurrent rectal cancer and additionally decreases the risk of toxicity, thus enabling the application of high dose radiotherapy

Keywords

Recurrent rectal cancer,intraoperative radiation therapy,multimodal treatment

Nüks Rektum Kanserinde İntraoperatif Radyoterapi

Öz

Giriş: Lokal ileri ve nüks rektum kanserinde multimodal tedavi seçeneklerden biri olan intraoperatif radyoterapi İORT , lokal kontrolü sağlamak için tercih edilebilir. Bu çalışmada nüks rektum kanseri nedeniyle radikal cerrahi ve intraoperatif radyoterapi uyguladığımız hastalar üzerindeki deneyimimizi sunmayı amaçladık.Metod: Acıbadem Mehmet Ali Aydınlar Üniversitesi Tıp Fakültesi, Maslak Hastanesi’nde Kasım 2012 ve Aralık 2016 tarihleri arasında nüks rektum kanseri nedeniyle radikal cerrahi ve İORT uygulanan hastaların klinik özellikleri ve ameliyat sonrası takipleri değerlendirildi.Bulgular: Çalışmamıza nüks rektum kanseri olan 8 hasta 4 kadın dahil edildi. Tüm hastalarda nüks adenokarsinom mevcuttu. Hastaların ortanca yaş değeri 54.5 ve vücut kitle indeksi 24.3 19.6-32.5 kg/m2 idi. Rektum kanseri için yapılan ilk ameliyatların tümü sfinkter koruyucu rezeksiyondu. Nüks tümör nedeniyle 4 hastaya aşağı anterior rezeksiyon, 2 hastaya abdominoperineal rezeksiyon, 2 hastaya da pelvisten kitle çıkarılması işlemi uygulandı. 5 hastaya R0, 2 hastaya R1 ve 1 hastaya R2 rezeksiyon yapıldı. Ameliyat sonrası erken dönem takiplerinde 2 hastada cerrahi yara enfeksiyonu gelişti. Ortanca hastanede kalış süresi 8 gündü. Ortanca 35.5 aylık takip süresince 4 hasta hastalıksız takip edilmektedir. İki hastada pelvik nüks gelişti. İki hasta eksitus oldu.Sonuç: Nüks rektum kanserinde intraoperatif radyoterapi, toksisite riskini azaltarak yüksek doz radyoterapi uygulayabilmemize olanak sağlayan ve bu yolla cerrahinin lokal kontrol üzerindeki etkinliğini artıran bir yöntemdir

Anahtar Kelimeler

Nüks rektum kanseri,intraoperatif radyoterapi,multimodal tedavi

References

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Details

Primary Language

Turkish

Subjects

-

Journal Section

-

Authors

İsmail Ahmet Bilgin

Erman Aytaç

İlknur Erenler Bayraktar

Bilgehan Şahin

Banu Atalar

Nuran Beşe

Enis Özyar

Bilgi Baca

İsmail Hamzaoğlu

Tayfun Karahasanoğlu

Publication Date

September 1, 2019

Submission Date

-

Acceptance Date

-

Published in Issue

Year 2019 Number: 3

IZ

https://izlik.org/JA72HK22WN

Cite

RIS / Bibtex

EndNote

Bilgin İA, Aytaç E, Bayraktar İE, Şahin B, Atalar B, Beşe N, Özyar E, Baca B, Hamzaoğlu İ, Karahasanoğlu T (September 1, 2019) Nüks Rektum Kanserinde İntraoperatif Radyoterapi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 3 473–477.