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RECTALCCRT

Dec 05, 20232 min read

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🌱來自: snippets

RECTALCCRT

Rectal cancer, 0 cm from anal verge, cTxNxM0, dx on 2010/00/00 (W/D) adenocarcinoma, 2010/00/00, under preop short course RT (2500cGy/5fr, 2010/00/00~00/00) to pelvis and bil inguinal areas, consolidatin chemotherapy (pending)

  • Initial presentation: bloody stool, tenesmus, decreased stool caliber and bowel habit change from once/day to several times/day
  • Treatment plan: preop induction short course RT follow by consolidation chemotherapy and then LAR or APR
  • 2010/00/00: Explain the purpose of neoadjuvant CCRT, the goal is to decrease recurrence/metastasis as possible, not guarantee cure!! Thus regular follow up is still needed.
  • 2010/00/00 Explain theconcept of CCRT→ OP then adjuvant C/T for localized advanced rectal cancer (stage II and III). As for pre-OP CCRT, options include: 1> Long course: CCRT(5 weeks) , followed by surgery and adjuvant chemotherapy. C/T options included continous 5-FU infusion on W1/W5 or XELODA with RT(self-paid, 825mg/m2 bid 5d/wk 5 weeks) 2> Short course: induction RT1 weeks followed by 1 week rest then mFOLFOX63 (self-paid oxaliplatin) cycles then restaging and surgery (LAR or APR) on 4th or 5th weeks after the last cycle of C/T. Post op adjuvant mFOLFOX69 cycles
  • Restaging on 6-7th week and refer to CRS on 8th week. Restaging with tumor marker, sigmoidoscopy, pelvic MRI, CXR, and liver sonography, low dose CT if has pulmonary nodules or hepatic lesions for follow up. @ Patient decided mFOLFOX6, explain self-paid oxaliplatin @ Arrange admission for #1 mFOLFOX-6 on 2010/00/00 and check lab, and arrange admission @ Vascular assessment, nutritional assessment, dental check, pharmacist education before chemotherapy.

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