Preoperative radiotherapy of rectal cancer--influence of fractionation and dose.
OBJECTIVE
We have been focused on patients with preoperative irradiation and compared two modes of radiotherapy, short-term (15 days) and long-term (45 days).


METHODS
Monitored group of 183 patients who had undergone a preoperative irradiation between 01/01/1998 and 12/31/2002 were irradiated in two modes: with a dose of 45Gy applied in 25 fractions/1.8Gy per fraction (CFD45) and a dose of 34.5Gy in 15 fractions/2.3Gy per fraction (CFD34.5).


RESULTS
No statistically significant difference in the occurrence of acute and postoperative complications, of locoregional recurrences and secondary dissemination, was mentioned in either group. In patients irradiated with CFD34.5 amputation of the rectum followed in 55%, and unlike the group irradiated with CFD45 the percentage of amputations was significantly lower (42%). We have recorded the average 5-year overall survival (OS) in those irradiated with CFD4.5 in 54% versus 61% in those irradiated with CFD45. More considerable conclusion was made comparing a 5-year disease-specific survival (DSS) versus the mode of irradiation, CFD34.5 57%, versus CFD45 71%. The significance level reached 10% (p = 0.057).


CONCLUSIONS
Pre-operative irradiation of the rectal cancer with the dose of 45Gy in 25 fractions/dose of 1.8Gy per fraction is a standard recommended procedure.
Kubecová
M
M
Dpt. Radiotherapy and Oncology, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
Korínek
P
P
Sejdová
M
M
Ambrus
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000209:etiology; D011300:Preoperative Care; D011879:Radiotherapy Dosage; D012004:Rectal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome