According to a new study, preoperative chemotherapy (neoadjuvant therapy overall) has several advantages over traditional approaches to the treatment of locally advanced rectal cancer.
Overall, neoadjuvant therapy has been developed to optimize the delivery of systemic drugs aimed at micrometastases. To explore its effectiveness, the team analyzed data on patients treated in the period from 2009 to 2015. Of these, 320 people received preoperative chemoradiotherapy with the planned adjuvant therapy. A further 308 patients underwent total neoadyuvatnuyu therapy comprising administering FU and oxaliplatin-based chemotherapy.
The use of neoadjuvant therapy was associated with a better dosage of chemotherapeutic agents. For example, an analysis of reception fluorouracil showed that 95% of people receiving neoadjuvant treatment, passed over six cycles of chemotherapy compared with 83% of the other group. Similar results were obtained when analyzing the receiving oxaliplatin.
Non-surgical treatment was more common in the group neoadyuvatnoy therapy, of which 24% of the patient is not subjected to surgery within 12 months, compared to 8% in the second group. In addition, minimally invasive surgery is often performed in the first group (72% vs. 47%).
"We hope that neoadjuvant therapy would lead to an increase in overall survival in patients" - reported the scientists. They noted that the holding of this type of treatment may improve the response to chemotherapy drugs and reduce the number of tumors. This will allow more people to be subjected to surgery (watch and wait). In addition, a temporary iliostoma patients can get rid of the last for 6-12 weeks (rather than the traditional 6-8 weeks).