Abdominoperineal resection combined with pre- and postoperative radiation therapy in the treatment of low-lying rectal carcinoma.
OBJECTIVE
A series of patients with rectal carcinoma irradiated by a sandwich technique combined with surgery is retrospectively analyzed.


METHODS
From 1978 to 1991, 155 patients with low or mid rectal carcinoma received abdominoperineal resection combined with a preoperative irradiation regimen of 35 Gy delivered in 14 fractions of 2.5 Gy each over a period of 3.5 weeks. The dose was increased to 45 Gy in the case of tumor fixation. According to histopathological findings, this irradiation was complemented in 87 cases by a postoperative dose of 25 Gy delivered in 10 fractions, for a total dose of 60 Gy delivered in the posterior pelvis.


RESULTS
Five-year survival was 66.8% for the entire population. The 5-year actuarial local control rate was 77.6%. Carcinologic results and toxicity were analyzed according to the pathological findings and the modalities of radiation therapy.


CONCLUSIONS
The postoperative boost after a preoperative moderate dose of irradiation seems to have no utility. Thus, this sandwich technique is not recommended.
Lusinchi
A
A
Département de Radiothérapie, Institut Gustave Roussy, Villejuif, France.
Wibault
P
P
Lasser
P
P
Elias
D
D
Bourrhis
J
J
Rougier
P
P
Ducreux
M
M
Duvillard
P
P
Eschwege
F
F
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003967:Diarrhea / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D012004:Rectal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate