Prognostic evaluation of preoperative combined treatment for advanced cancer in the lower rectum with radiation, intraluminal hyperthermia, and 5-fluorouracil suppository.
BACKGROUND
Since 1977, we have studied preoperative treatments using 5-fluorouracil (5-FU) suppositories alone or in combination with radiation to reduce local recurrence and improve survival of patients with rectal cancer.


METHODS
We developed a novel preoperative therapy combining radiation, intraluminal hyperthermia, and 5-FU suppositories. Thirty-five patients with rectal cancer underwent surgery after this treatment, and 41 patients underwent surgery without pretreatment.


RESULTS
The patients who underwent preoperative combination treatment showed significant tumor reduction; 2 achieved microscopically complete regression. In comparison with the patients who underwent surgery without pretreatment, the preoperative treatment group had a 16.7% lower local recurrence rate (10.4% versus 27.1%) and an improved survival rate (81.8% versus 67.6%).


CONCLUSIONS
Preoperative combination therapy is a promising modality for the patients with respectable advanced cancer in the lower rectum.
Ichikawa
D
D
First Department of Surgery, Kyoto Prefectural University of Medicine, Japan.
Yamaguchi
T
T
Yoshioka
Y
Y
Sawai
K
K
Takahashi
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011379:Prognosis; D012004:Rectal Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*; D012074:Remission Induction; D013488:Suppositories; D015996:Survival Rate
D000964:Antimetabolites, Antineoplastic; D013488:Suppositories; D005472:Fluorouracil