title: [Preoperative chemoradiotherapy for advanced lower rectal carcinoma].
abstract: Preoperative chemoradiotherapy in combination with radiation of 30 Gy and chemotherapy with oral uracil-tegafur for 14 patients with advanced lower rectal carcinoma was performed. Tumors were located at RaRb in 5 cases, RbRa in 2, Rb in 3, and RbP in 4 with a mean diameter of 3.8 cm. Preoperative lymphnodes were diagnosed as cN0 in 8 cases, cN1(metastases of perirectal nodes)in 4, cN1(perirectal and along superior rectal artery nodes)in 1, and cN3(perirectal and lateral nodes)in 1. Efficacy for primary carcinomas was evaluated as Partial Response in 9 cases, Stable Disease in 5 and perirectal nodes were down-sized in 4 without down-sizing of either along superior rectal artery nodes or lateral nodes. Margins of primary carcinomas to anal verge were prolonged in 7 cases with a mean prolongation of 0.81 cm. Autonomic nerve-preserving resections with lymphadenectomy of perirectal and along superior rectal artery nodes were performed. Histopathologically efficacy for primary tumors was diagnosed to as not effective in 9 cases, partially effective in 5, and all lymphnodes were combined with necroses and fibrosis. Preoperative chemoradiotherapy is safe for preserving autonomic nerves and serves to preserve the sphincter. A forthcoming study with more appropriate radiation, chemotherapy and lymphadenectomy is being considered.
authors.affiliation: Dept. of Surgery, Sunagawa City Medical Center.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Matsuhisa
authors.forename: Kouichi
authors.initials: K
authors.lastname: Taguchi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Fukumori
authors.forename: Atsushi
authors.initials: A
authors.lastname: Imai
authors.forename: Masaoki
authors.initials: M
authors.lastname: Minato
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery
chemical_list: D000970:Antineoplastic Agents