Influence of preoperative (hyperthermic) radiochemotherapy on manometric anal sphincter function in locally advanced rectal cancer

被引：8
作者：
Fritzmann J. [1 ]
Hünerbein M. [1 ]
Slisow W. [1 ]
Gellermann J. [2 ]
Wust P. [2 ]
Raul B. [1 ,3 ]
机构：
[1] Klin. F Chir. und Chir. Onkologie, Universitatsklinikum Charite, Humboldt-Universität zu Berlin, Berlin
[2] Klinik für Strahlenheilkunde, Universitatsklinikum Charite, Humboldt-Universität zu Berlin, Berlin
[3] Klin. F Chir. und Chir. Onkologie, Robert-Rössle-Klinik am MDC, Humboldt-Universität zu Berlin, 13125 Berlin
来源：
Strahlentherapie und Onkologie | 2004年 / 180卷 / 5期
关键词：
Manometry; Rectal cancer; Sphincter;
D O I：
10.1007/s00066-004-1173-x
中图分类号：
学科分类号：
摘要：
Background and Purpose: Preoperative radiochemotherapy (RCT) followed by curative surgery is a well-accepted therapeutic option in the treatment of advanced rectal cancer. Usually, the anal sphincter is located in the irradiation area of a preoperative RCT regime. The aim of this study is to evaluate the influence of preoperative RCT on anal sphincter function. Patients and Methods: Between 1994 and 2000, 102 patients with rectal cancer stage uT3/uT4 were analyzed. All patients underwent radiotherapy with 45 Gy (5 × 1.8 Gy) including two cycles of 5-fluorouracil (5-FU)/leucovorin (folinic acid) chemotherapy. 46 patients were treated additionally with up to five sessions of locoregional hyperthermia. The sphincter function was analyzed by perfusion manometry before preoperative therapy and 4 weeks after pretreatment had been finished. For statistics, the Wilcoxon signed rank test and Mann-Whitney U-test were used (SPSS 9.0 for Windows®). Results: The mean value of all 102 patients showed a significant reduction of the mean maximum resting pressure from 97 to 89 mmHg (p = 0.02). For the mean maximal squeeze pressure no significant difference could be shown (178 vs. 176 mmHg). For patients with distal (≤ 7.5 cm from anal verge) tumors the difference was highly significant (92 vs. 79 mmHg). Locoregional hyperthermia had no additional influence on sphincter function. Conclusion: Preoperative RCT impairs sphincter function especially in patients with distal tumors. In addition, RCT could have a negative influence on the continence of patients who received sphincter-preserving surgery.
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页码：281 / 288
页数：7
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