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Title: Use of Multiple Radiomodifiers May Offer Locoregional Tumour Control in Rectal Cancer: Presented at ESSO
URL: http://www.pslgroup.com/dg/22BE8A.htm
Doctor's Guide
September 11, 2008

By Shazia Qureshi

THE HAGUE, Netherlands -- September 11, 2008 -- Adding hyperthermia and metronidazole to preoperative radiation therapy may offer locoregional tumour control in patients with primary resectable rectal cancer, researchers reported here at the 14th Congress of the European Society of Surgical Oncology (ESSO).

"Polyradiomodification is feasible and effective," said researcher Zaman Mammadli, MD, Department of Colorectal Cancer, N.N. Blokhin Cancer Research Centre, Moscow, Russia, who presented the findings on September 10.

For their randomised study, Dr. Mammadli and colleagues enrolled 625 patients with histologically proven rectal cancer and T2 or T3 lesions seen on ultrasound and computed tomography.

Patients were randomised to 1 of 3 treatment groups: 276 patients received radiation therapy alone; 224 received radiation plus hyperthermia; 125 received radiation plus hyperthermia plus metronidazole. Ten patients in the hyperthermia group were also given capecitabine at an oral daily dose of 1.5 g/m² on each day of radiotherapy.

Radiation was administered at 5 Gy daily for 5 days. Hyperthermia was administered intrarectally just before radiation (on days 3, 4, and 5) for 60 minutes of exposure at a frequency of 460 MHz, with the tumour temperature reaching 44 degrees Celsius. Metronidazole gel 10 g/m² was administered for 5 hours of exposure prior to the hyperthermia treatment on days 3 and 5 of radiation therapy.

All patients underwent resection surgery 3 to 5 days after radiation treatment was completed.

Results showed that disease-free survival rates at 3 years were 72% in patients given radiation only, 75% in patients on radiation plus hyperthermia, and 97.3% in the group receiving the metronidazole combination treatment.

In the metronidazole group, no patient showed local tumour recurrence at 37 months of follow-up, and 1 patient had a liver metastasis. The rates of local recurrence were 11.1% in the radiation-only group and 4.7% in the radiation plus hyperthermia group.

"Polyradiomodification can be a way of increasing the efficacy of radiotherapy by increasing the radiosensitivity of the tumour," Dr. Mammadli concluded.


[Presentation title: Combined Modality Treatment of Rectal Cancer Using Polyradiomodifiers. Abstract 28]

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