title: Initial report from a Swedish multicentre study examining the role of preoperative irradiation in the treatment of patients with resectable rectal carcinoma. Swedish Rectal Cancer Trial.
abstract: Between March 1987 and February 1990, 1168 patients with resectable rectal cancer were recruited into a nationwide Swedish trial. Patients were randomly allocated to receive either preoperative irradiation (25 Gy in five fractions over 1 week) followed by surgery within 1 week, or surgery alone. In each group 454 patients underwent curative surgery. The groups were well matched for age, sex and surgical procedure. The postoperative mortality rates did not differ: 4 per cent after irradiation versus 3 per cent after surgery alone, but the postoperative mortality rate was significantly higher in patients treated with a two- rather than three- or four-portal technique (15 versus 3 per cent, P < 0.001). More perineal wound infections were found in patients receiving irradiation (20 versus 10 per cent, P < 0.001). No difference in the incidence of anastomotic dehiscence or other postoperative complication was found between the groups. Preoperative radiotherapy with a short-term high-dose technique can be delivered without major acute adverse effects, provided the irradiation technique is optimized.
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012004:Rectal Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*