No coin nor oath required. For personal study only.
Objectives: To consecutive phase II studies of pelvic rediotherapy (XRT), i.v. chemotherapy (CH) and TME surgery in T 3 or T 4 rectal cancer evaluated toxicity, chances of sphincter-saving surgery (SSS), local recurrence (LR) and survival. Methods: Were enrolled, 83 pts. in the ®rst trial (FUMIR) on TME following XRT (3,780 cGy in 21 days), 5-FU 1000 mg/m 2 days 1 to 4 and Mitomycin C (Mit.C) 10 mg/m 2 day 1 of XRT. Other 41 pts. underwent TME after XRT (5,040 cGy in 32 days), i.v. 5-FU 1000 mg/m 2 days 1 to 4 and 29 to 32 and i.v. CDDP mg/m 2 days 1 and 29 of XRT (second trial, PLAFUR). Six to 8 weeks after the end of neoadjuvant treatment all the pts. but one underwent TME surgery. Minimum follow-up was 24 months. Results: Toxicity ! G3 (WHO) was 10%; downstaging of T was observed in 60% of pts. and the pT 0 ones were 13%. SSS was carried out in 80% of pts. LR was 8.9%, 0% and 14.6% in all the stages, pT 0 no responders respectively. Five-yr. Overall and disease-free survival (OS and DFS) was 77.4% and 63.4%. Response to preoperative treatment was the most signi®cant prognostic factor: DFS was signi®cantly better in the pT 0±2 pts. (75.6% vs 47.4% in the pT 3 ; p .0002). At the multivariate analysis the T downstaging was the most signi®cantly favourable variable for local recurrence-free survival (p .04) while the N downstaging was for DFS (p .006). Conclusions: In the T 3 or T 4 rectal cancer a combined treatment may provide the best locoregional control of disease and maximize chances of SSS.
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## Introduction: The exact role of copper and zinc in the aetiology of cancer gallbladder is unclear. Some studies suggest the Cu/Zn ratio is a good indicator of the extent and prognosis in carcinoma of the gastrointestinal tract. The aim of the present study was to estimate the micronutrient profi