title: A short course of preoperative radiotherapy improves prognosis of operable rectal carcinoma: a case control study.
abstract: OBJECTIVE
  Randomized Swedish studies demonstrate the efficacy of a 5-fraction course of preoperative radiotherapy for rectal carcinoma. The present study evaluates the results in a single Greek institution over a 10-year period, with a similar regimen.
  
  
  METHODS
  During the period of 1995-2000, 150 consecutive patients with Dukes' B or C rectal cancer were matched to receive preoperative radiotherapy (Group I) or not (Group II). Seventy-five patients received pelvic radiotherapy of 2500cGY/5 fractions, followed by surgery within one week. Radiotherapy was delivered through 4 portals, with the patient lying in the prone position. A CT scan was used to define treatment volume. The 5-fraction course was used for lesions that seemed readily resectable. Patients in both groups received adjuvant chemotherapy. Local recurrence, disease-free interval and 5-year survival were evaluated and analyzed.
  
  
  RESULTS
  The disease-free interval was significantly longer in Group I (p < 0.0005). This benefit was mainly due to a significantly lower incidence of local recurrence in Group I (9/75, 12%) compared with Group II (30/75, 40%) (p < 0.0005). The incidence of distant metastases was not significantly different between the 2 groups. The 5-year survival for all patients, who underwent "curative" surgery was significantly higher in Group I (77.3%) as compared to Group II (39%), (p < 0.0005).
  
  
  CONCLUSIONS
  Patients with resectable rectal cancer who received 2500cGy/5 fractions preoperative radiotherapy to the pelvis had excellent local control of disease, longer disease-free interval and higher 5-year survival than patients who did not. These patients were able to undergo sphincter preserving surgery and adjuvant chemotherapy.
authors.affiliation: 2nd Surgical Department, Aristotle University of Thessaloniki, G. Papanikolaou Regional General Hospital, Greece. baspen@otenet.gr
authors.forename: V
authors.initials: V
authors.lastname: Penopoulos
authors.forename: M
authors.initials: M
authors.lastname: Handolias
authors.forename: A
authors.initials: A
authors.lastname: Avgerinos
authors.forename: T
authors.initials: T
authors.lastname: Maris
authors.forename: T
authors.initials: T
authors.lastname: Ilias
authors.forename: N
authors.initials: N
authors.lastname: Issopoulos
authors.forename: G
authors.initials: G
authors.lastname: Christianopoulos
authors.forename: D
authors.initials: D
authors.lastname: Betsis
authors.forename: E
authors.initials: E
authors.lastname: Vrettou
authors.forename: G
authors.initials: G
authors.lastname: Kitis
authors.forename: K
authors.initials: K
authors.lastname: Pistevou
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D000368:Aged; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D016896:Treatment Outcome