摘要
<strong>Background</strong><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> Radiation therapy is an essential treatment for rectal cancer. In 2018, Senegal experienced a transition from two-dimensional to three-dimensional radiotherapy (RC3D). We are evaluating for the first time the impact of this RC3D in the treatment of rectal cancer in Senegal. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To describe </span><span style="font-family:Verdana;">the epidemiological, clinical and diagnostic profile of rectum cancer in</span><span style="font-family:Verdana;"> Senegal, to list the different radiotherapy techniques used, to evaluate the response as </span><span><span style="font-family:Verdana;">well as the outcome of patients. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> We conducted a retrospective</span></span><span> </span><span style="font-family:Verdana;">descriptive study on preoperative radio-chemotherapy of rectal adenocarcinoma at the Dalal Jamm University Hospital in Dakar from July 2018 to June 2020. </span><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;">: The 42 patients included, including 18 men and 24 women (Sex Ratio: 0.75), had an average age of 55.9 years. We found a family history of CRC (Colorectal cancer) in 7 cases and smoking in 5 cases. The clinical signs were dominated by rectal bleeding, noted in 92.8% of cases, with or without pain, and changes in transit in 57.1% and 50% respectively. The tumor was perceptible on digital rectal examination (DRE) in 76.1%. All patients had undergone endoscopy, which revealed a budding aspect in 69% of cases. The preferred location was the lower rectum (59.5%). The predominant histological type was liberkhunian adenocarcinoma (85.7%). T3 and T4 tumors accounted for 30.9% and 21.4% of cases respectively and stage III was predominant, 69%. The aim of radiotherapy was curative in 33 patients and palliative in 9 patients. Curative radiotherapy was preoperative in 29 patients and adjuvant in 2 patients. RC3D was the technique used in all our patients and the total dose of 50.4 Gy in 28 sessions of 5 days per week was the most used (69%). The incidents noted during radiotherapy were 12 cases of radiodermatitis, 15 cases of diarrhea, and no severe toxicity was noted. Thirty-one patients underwent surgery, 16 with anterior resection of the rectum and 3 with total proctectomy;the sphincter preservation rate was 61.2%. The surgical resection was carcinological (R0) in 26 patients and microscopically incomplete (R1) in 5 patients. Post-operative evaluation of the pathological specimen showed a complete histological response in 21% of cases. The evolution was marked by a progressive disease in 4 cases, local recurrence in 3 cases, metastatic recurrence in 4 cases, death in 8 cases and remis</span><span style="font-family:Verdana;">sion in 23 cases. The average follow-up of our patients was 17.3 months.</span> <b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Rectal cancer is diagnosed late in Senegal;surgery remains the cornerstone of treatment. Radiotherapy increases the resectability and local control.</span></span>
<strong>Background</strong><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> Radiation therapy is an essential treatment for rectal cancer. In 2018, Senegal experienced a transition from two-dimensional to three-dimensional radiotherapy (RC3D). We are evaluating for the first time the impact of this RC3D in the treatment of rectal cancer in Senegal. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To describe </span><span style="font-family:Verdana;">the epidemiological, clinical and diagnostic profile of rectum cancer in</span><span style="font-family:Verdana;"> Senegal, to list the different radiotherapy techniques used, to evaluate the response as </span><span><span style="font-family:Verdana;">well as the outcome of patients. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> We conducted a retrospective</span></span><span> </span><span style="font-family:Verdana;">descriptive study on preoperative radio-chemotherapy of rectal adenocarcinoma at the Dalal Jamm University Hospital in Dakar from July 2018 to June 2020. </span><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;">: The 42 patients included, including 18 men and 24 women (Sex Ratio: 0.75), had an average age of 55.9 years. We found a family history of CRC (Colorectal cancer) in 7 cases and smoking in 5 cases. The clinical signs were dominated by rectal bleeding, noted in 92.8% of cases, with or without pain, and changes in transit in 57.1% and 50% respectively. The tumor was perceptible on digital rectal examination (DRE) in 76.1%. All patients had undergone endoscopy, which revealed a budding aspect in 69% of cases. The preferred location was the lower rectum (59.5%). The predominant histological type was liberkhunian adenocarcinoma (85.7%). T3 and T4 tumors accounted for 30.9% and 21.4% of cases respectively and stage III was predominant, 69%. The aim of radiotherapy was curative in 33 patients and palliative in 9 patients. Curative radiotherapy was preoperative in 29 patients and adjuvant in 2 patients. RC3D was the technique used in all our patients and the total dose of 50.4 Gy in 28 sessions of 5 days per week was the most used (69%). The incidents noted during radiotherapy were 12 cases of radiodermatitis, 15 cases of diarrhea, and no severe toxicity was noted. Thirty-one patients underwent surgery, 16 with anterior resection of the rectum and 3 with total proctectomy;the sphincter preservation rate was 61.2%. The surgical resection was carcinological (R0) in 26 patients and microscopically incomplete (R1) in 5 patients. Post-operative evaluation of the pathological specimen showed a complete histological response in 21% of cases. The evolution was marked by a progressive disease in 4 cases, local recurrence in 3 cases, metastatic recurrence in 4 cases, death in 8 cases and remis</span><span style="font-family:Verdana;">sion in 23 cases. The average follow-up of our patients was 17.3 months.</span> <b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Rectal cancer is diagnosed late in Senegal;surgery remains the cornerstone of treatment. Radiotherapy increases the resectability and local control.</span></span>
