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Postoperative radiation therapy for high-risk colon carcinoma.

Publication ,  Journal Article
Willett, CG; Fung, CY; Kaufman, DS; Efird, J; Shellito, PC
Published in: J Clin Oncol
June 1993

PURPOSE: This study examines the experience of patients treated with postoperative radiation therapy after resection of high-risk colon carcinoma in an effort to assess the potential role of this modality in combination with current systemic therapies. PATIENTS AND METHODS: From 1976 to 1989, 203 patients received postoperative radiation therapy with and without concurrent fluorouracil (5-FU) chemotherapy following resection of modified Astler-Coller B2, B3, C2, and C3 colon tumors. Of the 203 patients, 30 (15%) were identified as having residual local tumor after subtotal resection, whereas 173 (85%) had no known residual disease. The 173 patients treated with adjuvant radiation therapy were compared with a historical control group of 395 patients undergoing surgery only. RESULTS: Three groups of patients who appeared to benefit from postoperative radiation were identified. Improved local control and recurrence-free survival rates were seen for patients with stage B3 and C3 colon carcinoma treated with postoperative radiation therapy compared with a similarly staged group of patients undergoing surgery only. Irradiated patients whose tumors had an associated abscess or fistula formation had improved local control and recurrence-free survival rates compared with a similar group of patients undergoing surgery only. There appears to be a subset of patients with residual local disease after subtotal resection that may be salvaged by high-dose postoperative radiation therapy. CONCLUSION: Selected groups of patients with colon carcinoma may benefit from postoperative radiation in addition to current systemic therapies. Integration of 5-FU and levamisole with postoperative radiation therapy should be considered for patients with (1) stage B3 and C3 lesions, (2) tumors associated with abscess or fistula formation, and (3) residual local disease after subtotal resection.

Duke Scholars

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

June 1993

Volume

11

Issue

6

Start / End Page

1112 / 1117

Location

United States

Related Subject Headings

  • Survival Rate
  • Risk Factors
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Lymphatic Metastasis
  • Humans
  • Fluorouracil
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Willett, C. G., Fung, C. Y., Kaufman, D. S., Efird, J., & Shellito, P. C. (1993). Postoperative radiation therapy for high-risk colon carcinoma. J Clin Oncol, 11(6), 1112–1117. https://doi.org/10.1200/JCO.1993.11.6.1112
Willett, C. G., C. Y. Fung, D. S. Kaufman, J. Efird, and P. C. Shellito. “Postoperative radiation therapy for high-risk colon carcinoma.J Clin Oncol 11, no. 6 (June 1993): 1112–17. https://doi.org/10.1200/JCO.1993.11.6.1112.
Willett CG, Fung CY, Kaufman DS, Efird J, Shellito PC. Postoperative radiation therapy for high-risk colon carcinoma. J Clin Oncol. 1993 Jun;11(6):1112–7.
Willett, C. G., et al. “Postoperative radiation therapy for high-risk colon carcinoma.J Clin Oncol, vol. 11, no. 6, June 1993, pp. 1112–17. Pubmed, doi:10.1200/JCO.1993.11.6.1112.
Willett CG, Fung CY, Kaufman DS, Efird J, Shellito PC. Postoperative radiation therapy for high-risk colon carcinoma. J Clin Oncol. 1993 Jun;11(6):1112–1117.

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

June 1993

Volume

11

Issue

6

Start / End Page

1112 / 1117

Location

United States

Related Subject Headings

  • Survival Rate
  • Risk Factors
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Lymphatic Metastasis
  • Humans
  • Fluorouracil
  • Female