Imperial College London
Alternate

Chris Rao

Faculty of Medicine, Department of Surgery & Cancer

Honorary Clinical Research Fellow
 
 
 
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christopher.rao Website

 
 
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Summary

 

Publications

Citation

BibTex format

@article{Sun:2017:10.1259/bjr.20170175,
author = {Sun, Myint A and Smith, FM and Gollins, SW and Wong, H and Rao, C and Whitmarsh, K and Sripadam, R and Rooney, P and Hershman, MJ and Fekete, Z and Perkins, K and Pritchard, DM},
doi = {10.1259/bjr.20170175},
journal = {British Journal of Radiology},
pages = {1--11},
title = {Dose escalation using contact x-ray brachytherapy (Papillon) for rectal cancer. Does it improve the chance of organ preservation?},
url = {http://dx.doi.org/10.1259/bjr.20170175},
volume = {90},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective:A watch and wait policy for patients with a clinical complete response (cCR) after external beam chemoradiotherapy (EBCRT) for rectal cancer is an attractive option. However, approximately one-third of tumours will regrow, which requires surgical salvage for cure. We assessed whether contact X-ray brachytherapy (CXB) can improve organ preservation by avoiding surgery for local regrowth.Methods:From our institutional database, we identified 200 of 573 patients treated by CXB from 2003 to 2012. Median age was 74 years (range 32–94), and 134 (67%) patients were males. Histology was confirmed in all patients and was staged using CT scan, MRI or endorectal ultrasound. All patients received combined CXB and EBCRT, except 17 (8.5%) who had CXB alone.Results:Initial cCR was achieved in 144/200 (72%) patients. 38/56 (68%) patients who had residual tumour received immediate salvage surgery. 16/144 (11%) patients developed local relapse after cCR, and 124/144 (86%) maintained cCR. At median follow up of 2.7 years, 161 (80.5%) patients were free of cancer. The main late toxicity was bleeding (28%). Organ preservation was achieved in 124/200 (62%) patients.Conclusion:Our data suggest that CXB can reduce local regrowth to 11% compared with around 30% after EBCRT alone. Organ preservation of 62% achieved was higher than reported in most published watch and wait studies.Advances in knowledge:CXB is a promising treatment option to avoid salvage surgery for local regrowth, which can improve the chance of organ preservation in patients who are not suitable for or refuse surgery.
AU  - Sun,Myint A
AU  - Smith,FM
AU  - Gollins,SW
AU  - Wong,H
AU  - Rao,C
AU  - Whitmarsh,K
AU  - Sripadam,R
AU  - Rooney,P
AU  - Hershman,MJ
AU  - Fekete,Z
AU  - Perkins,K
AU  - Pritchard,DM
DO  - 10.1259/bjr.20170175
EP  - 11
PY  - 2017///
SN  - 0007-1285
SP  - 1
TI  - Dose escalation using contact x-ray brachytherapy (Papillon) for rectal cancer. Does it improve the chance of organ preservation?
T2  - British Journal of Radiology
UR  - http://dx.doi.org/10.1259/bjr.20170175
UR  - https://www.birpublications.org/doi/10.1259/bjr.20170175
UR  - http://hdl.handle.net/10044/1/104142
VL  - 90
ER  -
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