Rectal squamous cell carcinoma treated with chemoradiotherapy: report of six cases.
OBJECTIVE
Squamous cell carcinoma (SCC) of the colon and rectum is a rare pathologic entity. From May 2006 to August 2008 six consecutive patients with SCC of the rectum were treated at our institution. A retrospective analysis of these cases was performed in order to evaluate the role of chemoradiotherapy as an alternative to surgery.


METHODS
All tumors were locally advanced and the clinical stage was T3N0M0 in three cases, T3N1M0, T4N1M0 and T3N2M1 in the other three cases. All patients received primary chemoradiation reserving surgery for unresponsive or recurrent tumors except in one of complete responders. Radiation treatment was given to standard pelvic volume up to 50.4 Gy in 28 fractions, with a boost to the primary tumor up to 59.4 Gy in two patients.


RESULTS
A complete clinical response with a negative endoscopic biopsy was achieved in four patients and a partial response in two. Surgery as a part of the primary treatment was performed in the non-metastatic patient with partial response and in the first patient with complete response. At a median follow-up of 39 months (range, 24-41) from the end of chemoradiotherapy, five out of six patients remain alive and free of recurrence, three of them without having undergone surgery.


CONCLUSIONS
Our data, though from a small series, give support to the hypothesis that concomitant chemoradiation may be considered a safe and effective therapeutic approach for patients with rectal SCC.
Tronconi
Maria Chiara
MC
Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, Via Manzoni 56, 20089, Rozzano, Milan, Italy. maria_chiara.tronconi@humanitas.it
Carnaghi
Carlo
C
Bignardi
Mario
M
Doci
Roberto
R
Rimassa
Lorenza
L
Di Rocco
Mariagrazia
M
Scorsetti
Marta
M
Santoro
Armando
A
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000628:therapy; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D012004:Rectal Neoplasms / Q000532:radiotherapy* / Q000628:therapy; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome