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  • Liproxstatin-1 br Results As of June patients were

    2020-08-05


    Results: As of June 2018, 11 patients were recruited. One was excluded from the analysis for presenting severe toxicity, suggestive of dihydropyrimidine dehydrogenase (DPD) defi-ciency, after the first chemotherapy cycle. All others completed the treatment. Two patients presented toxicity grade 3/4 related to chemotherapy and had their doses reduced. Seven
    E-mail: [email protected] (C.R. Mendes).
    2237-9363/© 2018 Sociedade Brasileira de Coloproctologia. Published by Elsevier Editora Ltda. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
    Palavras-chave:
    Qualidade de vida
    cirurgia retal
    vigilância Watch and wait
    câncer retal 
    patients (70%) presented iRC; three underwent rectosigmoidectomy, and the anatomopatho-logical evaluation indicated complete pathological response in two cases (28.5%). Three (30%) presented cCR and did not present evidence of disease after a mean follow-up of 19 months. Patients presented improvement of anorectal function and quality of life.
    Conclusions: Advances in the neoadjuvant treatment of rectal tumors contributed to bet-ter rates of complete pathological responses. New paradigms promote an increase in the complete clinical response rates, which would allow organ preservation and consequent Liproxstatin-1 of surgical morbidity.
    © 2018 Sociedade Brasileira de Coloproctologia. Published by Elsevier Editora Ltda. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/
    Avaliac¸ ão do tratamento não cirúrgico de pacientes com câncer de reto submetido ao tratamento neoadjuvante com quimioterapia e radioterapia no servic¸ o de oncologia
    Objetivo: Descrever os resultados parciais de estudo em pacientes com câncer de reto submetidos a tratamento neoadjuvante com quimioterapia e radioterapia quanto à taxa resposta clínica completa, sobrevida livre de doenc¸ a, func¸ ão anorretal e qualidade de vida. Material e métodos: Estudo prospectivo desde junho 2015 até junho de 2018, em paciente com adenocarcinoma de reto baixo ou médio e estadio clínico II ou III tratados com RT/QT (IMRT 54 Gy em 6 semanas) concomitante a 5-Fuorouracil (5-FU) 380 mg/m2 e ácido folínico (LV) 20 mg/m2 por 5 dias nas primeira e quinta semanas e dois ciclos após RT (5-FU 400 mg/m2 e LV 20 mg/m2 ) a cada 28 dias. Após o tratamento, realizou-se exame clínico, retossigmoi-doscopia, RNM de pelve, TC de tórax e abdômen superior e dosagem de CEA. Naqueles com Resposta Clínica Incompleta (iRC) procedeu-se à cirurgia de ressecc¸ ão. Aqueles com Resposta Completa (cRC) estão em observac¸ ão (wait and see policy). Manometria e escalas de func¸ ão esfincteriana e qualidade de vida foram obtidas antes e após 30 e 90 dias do término do tratamento.
    Resultados: Até junho de 2018, recrutaram-se 11 pacientes. Um foi excluído da análise, pois apresentou toxicidade severa sugestiva de deficiência de DPD após o primeiro ciclo de QT. Todos os demais concluíram o tratamento. Toxicidades graus 3/4 relacionadas à QT ocor-reram dois pacientes, reduzindo-se sua dose. Sete (70%) apresentaram iRC, submetendo três
    à retossigmoidectomia cuja avaliac¸ ão anatomopatológica evidenciou Resposta Completa (pRC) em dois casos (28,5%). Três (30%) apresentaram cRC e estão sem evidência de doenc¸ a com seguimento médio de 19 meses. Houve melhora da func¸ ão anorretal e da qualidade de vida.
    Conclusões: Avanc¸ os no tratamento neoadjuvante dos tumores de reto contribuíram para melhores taxas de pRC. Novos paradigmas promovem crescentes índices de cRC, o que possibilitaria a preservac¸ ão do órgão e consequente reduc¸ ão da morbidade cirúrgica.
    © 2018 Sociedade Brasileira de Coloproctologia. Publicado por Elsevier Editora Ltda. Este e´ um artigo Open Access sob uma licenc¸ a CC BY-NC-ND (http://creativecommons.org/
    Introduction
    The standard treatment for rectal neoplasia is multidisci-plinary. Neoadjuvant chemotherapy and radiotherapy are considered the gold standard for the preoperative treatment in patients from clinical stage II onwards. In clinical stud-ies addressing locally advanced rectal cancer, neoadjuvant treatment presented advantages over adjuvant treatment, such as lower toxicity, greater tolerability, lower rate of local recurrence, better PFS, reduction of pathological staging, and greater probability of sphincter-sparing surgery.1,2 In 
    turn, no benefit was observed regarding to overall survival.2 Approximately 10% to 30% of neoadjuvant concomitant radiotherapy (RT) and chemotherapy (CHT) cancer patients present complete pathological response (cPR).3 Thus, patients with complete clinical response to RT/CHT could be spared from the morbimortality of the surgery, such as definitive colostomy and genitourinary and sexual dysfunction. With the objective of evaluating patients with rectal cancer sub-mitted to neoadjuvant treatment with RT/CHT regarding the rate of response to treatment, disease-free survival, anorectal function, and quality of life, a research was conducted in the