Surgery and OncologySurgery and OncologyХирургия и онкология2949-5857Publishing House ABV Press25210.17650/2220-3478-2018-8-2-63-72ORIGINAL REPORTSОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯTumor downstaging and therapeutic pathomorphosis in rectal cancer patients receiving combination therapy with various polyradiomodification regimensРедукция стадии заболевания и показатели лечебного патоморфоза при различных вариантах программы полирадиомодификации в схемах комбинированного лечения больных раком прямой кишкиVlasovO. A.ВласовО. А.
Russian Federation

24 Kashirskoe Shosse, Moscow 

Олег Александрович Власов 

115478 Москва, Каширское шоссе, 24

vlasoff@mail.ruBarsukovYu. A.БарсуковЮ. А.
Russian Federation

24 Kashirskoe Shosse, Moscow 

115478 Москва, Каширское шоссе, 24

https://orcid.org/0000-0001-8965-8172TkachevS. I.ТкачевС. И.
Russian Federation

24 Kashirskoe Shosse, Moscow 

115478 Москва, Каширское шоссе, 24

https://orcid.org/0000-0002-9303-8379GordeevS. S.ГордеевС. С.
Russian Federation

24 Kashirskoe Shosse, Moscow 

115478 Москва, Каширское шоссе, 24

TsaryukV. F.ЦарюкВ. Ф.
Russian Federation

24 Kashirskoe Shosse, Moscow 

115478 Москва, Каширское шоссе, 24

AlievV. A.АлиевВ. А.
Russian Federation

24 Kashirskoe Shosse, Moscow 

115478 Москва, Каширское шоссе, 24

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России120720188263721207201812072018Copyright ©; 2018, ABV-pressCopyright ©; 2018, АБВ-пресс2018ABV-pressАБВ-прессhttps://onco-surgery.info/jour/about/editorialPolicieshttps://onco-surgery.info/jour/article/view/252

Objective: to evaluate therapeutic pathomorphosis and Tand N-downstaging in response to various polyradiomodification regimens used in the combination therapy for rectal cancer.

Materials and methods. A total of 241 patients received combination therapy for rectal cancer using 4 different polyradiomodification regimens. We assessed therapeutic pathomorphosis and tumor downstaging in these patients. Eighty-two participants (34 %) underwent polyradiomodification with a 14-day course of capecitabine (Cap) given in a therapeutic dose (2 g/m2body surface) (Cap14 + metronidazole (MZ) and Cap14 + MZ + microwave hyperthermia (MW-HT)), whereas the remaining 159 participants (66 %) underwent polyradiomodification with a 5-day course of Cap in a radiosensitizing dose (1.5 g/m2 body surface) (Cap5 + MZ and Cap5 + MZ + MW-HT).

Results. Grade IV therapeutic pathomorphosis was observed in 19.5 % of patients treated with a 14-day course of Cap (Cap14 + MZ and Cap14 + MZ + MW-HT) and 1.3 % of patients treated with a 5-day course of Cap (Cap5 + MZ and Cap5 + MZ + MW-HT) (p = 0.00001). Patients receiving a 14-day course of Cap demonstrated T-downstaging significantly more often than those receiving a 5-day course (41.5 % compared to 9.4 % respectively, p = 0,00001). Regression of regional lymph node metastases was diagnosed in 51.1 % of patients from the Cap14 group only.

Conclusion. Our findings suggest that grade III–IV therapeutic pathomorphosis and tumor downstaging are more frequently achieved in polyradiomodification regimens with a 14-day course of Cap at a dose of 2 g/m2 (Cap14 + MZ and Cap14 + MZ + MW-HT).

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