title: Chemo-radiotherapy versus radiotherapy alone in the pre-operative treatment of resectable rectal cancer.
abstract: OBJECTIVE
  To determine the differences in downstaging, local control (LC), disease free survival (DFS) and overall survival (OS) between combined pre-operative chemoradiation and pre-operative radiotherapy alone in the treatment of resectable rectal cancer.
  
  
  METHODS
  One hundred and ten patients who underwent pre-operative radiotherapy or chemo-radiotherapy were reviewed. Fifty-seven patients were treated with radiotherapy (30 Gy/3 Gy) alone and 53 patients with chemo-radiotherapy (bolus 5FU+45 Gy/1.8 Gy). The median interval between the end of neo-adjuvant treatment and surgery was 28 and 46 days for the patients treated with radiotherapy alone and chemo-radiotherapy.
  
  
  RESULTS
  The groups were homogeneously distributed for all characteristics except for cN-stage with more clinically node positive patients in the combined modality treatment group (47 vs 73%). A significant downstaging for tumour and/or lymph node status was observed in both groups. More ypT0-x-is were observed after chemoradiation than after radiotherapy alone (26 vs 7%; p=0.02). The local control rate at 3 years was 94% for both groups. DFS after radiation and chemoradiation was comparable with a 3-year DFS of 83 and 88%, respectively.
  
  
  CONCLUSIONS
  Both pre-operative schemes have similar outcomes concerning DFS, OS and LC. Tumour downstaging is associated with improved survival.
authors.affiliation: Department of Radiation Oncology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. laurence.goethals@med.kuleuven.ac.be
authors.forename: L
authors.initials: L
authors.lastname: Goethals
authors.forename: K
authors.initials: K
authors.lastname: Haustermans
authors.forename: C
authors.initials: C
authors.lastname: Perneel
authors.forename: B
authors.initials: B
authors.lastname: Bussels
authors.forename: A
authors.initials: A
authors.lastname: D'Hoore
authors.forename: K
authors.initials: K
authors.lastname: Geboes
authors.forename: N
authors.initials: N
authors.lastname: Ectors
authors.forename: E
authors.initials: E
authors.lastname: Van Cutsem
authors.forename: W
authors.initials: W
authors.lastname: Van den Bogaert
authors.forename: F
authors.initials: F
authors.lastname: Penninckx
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000368:Aged; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate