title: [Our experiences of preoperative chemoradiotherapy for rectal cancer with invasion to adjacent organs].
abstract: We reviewed clinical records of 10 cases with preoperative chemoradiotherapy to evaluate the clinical effectiveness of the chemoradiotherapy for T4 rectal cancer. The preoperative radiation therapy consisted of 40-50 Gy delivered in fractions of 1.8-2.0 Gy per day for five days per week. A treatment of 5-fluorouracil (500 mg/body) per day intravenously, or oral UFT-E (300 mg/m2) with l-leucovorin (75 mg/body) per day, or oral S-1 (80 mg/m2) per day for five days per week, was given during radiotherapy. Grade 1 or 2 adverse effects occurred in 3 patients during chemoradiotherapy, but a completion of chemoradiotherpy was achieved in all of the 10 patients. Invasive findings to the adjacent organs identified by CT and MRI disappeared in 6 cases with complete or partial response 1 month after chemoradiotherapy. Although the adjacent organs were also removed during surgery in 7 patients, curative surgery was performed in 7 patients. There was no histological invasion to the adjacent organs in 4 patients, and one patient had a histological complete disappearance of tumor. Although complications after surgery were found in all of the patients, they were improved by conservative treatment. Two of 7 patients with curative surgery had recurrence, but the rest of them survived without recurrence. Preoperative chemoradiotherapy was expected to be a safe and effective treatment to improve the resection rate and prognosis for T4 rectal cancer.
authors.affiliation: Department of Surgery, Fujita Health University.
authors.forename: Harunobu
authors.initials: H
authors.lastname: Sato
authors.forename: Koutarou
authors.initials: K
authors.lastname: Maeda
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Hanai
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Koide
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsuoka
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Katsuno
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Agata
authors.forename: Tomohito
authors.initials: T
authors.lastname: Noro
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Honda
authors.forename: Miho
authors.initials: M
authors.lastname: Shiota
authors.forename: Shinji
authors.initials: S
authors.lastname: Ozeki
authors.forename: Kouhei
authors.initials: K
authors.lastname: Hatta
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D011879:Radiotherapy Dosage; D012004:Rectal Neoplasms / Q000473:pathology* / Q000628:therapy*