Effect of preoperative concurrent chemoradiotherapy in locally advanced low rectal cancer after radical resection surgery.
To evaluate the outcome of patients with locally advanced low rectal adenocarcinoma who required preoperative concurrent chemoradiotherapy (CCRT), a total of 22 patients underwent preoperative CCRT and radical resection for locally advanced low rectal adenocarcinoma. Patients received concurrent chemotherapy with high-dose 5-fluorouracil (5-FU) in continuous infusion and leucovorin and preoperative radiation with a mean dose of 50.4 Gy (range, 45-50.4 Gy). Radical resection surgery was performed 6 weeks after treatment. Fifty-five percent of patients achieved tumor downstaging, and 14% patients. showed pathological complete remission. No severe hematological and gastrointestinal toxicity of preoperative CCRT was noted. Sphincter-saving rate was 82%, and there were no deaths related to preoperative CCRT and surgery. Overall, 3-year survival rate was 69%, and a rate of locoregional recurrence was 13.6%. This study shows that many patients with locally advanced rectal cancer can be operated on with sphincter-saving radical resection surgery under good local control after preoperative concurrent chemoradiotherapy, which induces tumor downstaging.
Lam
Chung-Wah
CW
Department of Colorectal Surgery, Changhua Christian Hospital, Changhua, Taiwan.
Chen
William Tzu-Liang
WT
Liu
Mu-Tai
MT
Chang
Cheng-Shyong
CS
Huang
Teng-Min
TM
Hsu
Ger-Hau
GH
Chen
Hong-Chang
HC
Hsiao
Koung-Hong
KH
Chiu
Chien-Min
CM
You
Jau-Jie
JJ
D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D016019:Survival Analysis