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Shelyguin Yu.A.,Coloproctological Research Center | Rasulov A.O.,Coloproctological Research Center | Boiko A.V.,Pa Herzen Research Institute Of Oncology | Droshneva I.V.,Pa Herzen Research Institute Of Oncology
Voprosy Onkologii | Year: 2011

Complex treatment included preoperative radiochemotherapy (fractionated TTD of 47 Gy), 5-FU 2.75-3.5 g, cisplatin 90 mg, surgery and postoperative adjuvant chemotherapy (XELOX). The radiochemotherapy/ surgery interval ranged 21-72 days (average - 40; median - 41.2±7.9). Patients were divided into two groups: those operated on within days 21-40 (1) and days 41-72 (2) to evaluate the impact of the interval between surgery and completion of radiochemotherapy. The intervals longer than 40 days were not followed by longer sphincter-saving operations, higher intraoperative blood loss or postoperative complication incidence, as compared with the 21-40 day interval. Besides, radiochemotherapy-related alterations in tumor tissues arising more than 40 days after exposure were more pronounced, yet unaccompanied by significantly better end results. Source


Alexeyev M.V.,Coloproctological Research Center | Shelygin Yu.A.,Coloproctological Research Center | Revelsky I.A.,Moscow State University | Rybakov Ye.G.,Coloproctological Research Center
Voprosy Onkologii | Year: 2011

Neoadjuvant treatment should not be given to grave cases of rectal cancer with concomitant perifocal inflammation, anemia and advanced age. To improve results, intraoperative intrapelvic chemotherapy in combination with hyperthermia was carried out at the Center's Clinic. Pre-clinical studies involved working out optimal cryo-temporal regimens to maximize cytotoxic effects of drugs and hyperthermia as well as establishing systemic influence of local hyperthermia and chemotherapy on the intraoperative intrapelvic one. Our optimal cryo-temporal regimens and intraoperative intrapelvic chemotherapy proved highly effective. Source


Yeropkin P.V.,Coloproctological Research Center | Rybakov Ye.G.,Coloproctological Research Center | Kashnikov V.N.,Coloproctological Research Center | Panina M.V.,Coloproctological Research Center
Voprosy Onkologii | Year: 2011

While the most frequent, surgery for colorectal cancer is avoided in patients with metastases to the regional lymph nodes (stage III) or distant ones (stage IV). Hence, it is being increasingly substituted with neoadjuvant treatment. Our investigation is concerned with prospective evaluation of the efficacy and toxicity profile of capecitabine (XELODA) in combination with oxaliplatin (XELOX) and adjuvant Mayo treatment (stage IIb-III). Patients had undergone radical surgery (somatic status ≤2 -ECOG). The prospective group (166) received 8 courses of adjuvant polychemotherapy (XELOX); the retrospective (2001-2005) one (152) - 6 (Mayo). The groups matched one another as far as number, gender, age and primary tumor localization are concerned. Regional lymph node involvement in group 1 was 64.5%; group 2-59.8%. Lympho-vascular invasion by tumor was typical of group 1; gastrointestinal toxicity - 9.2% (Mayo) vs. 7.2% in group 1. Hematological complications were 5.4% (XELOX) and 5.3% (Mayo); neutropenia - 5.0% (Mayo) and 3.0% (XELOX); polyneutropenia - 3.6% (XELOX); capecitabine-related Papillon-Lefevre syndrome - 8.4%. Three-year relapse-free survival was 53.0% (XELOX) and 47.5 % (Mayo). After adjuvant treatment, toxicity profile with XELOX was lower than that after Mayo, with the survival tending to improve. Source

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