title: Clinical outcomes of chemoradiotherapy for locally recurrent rectal cancer.
abstract: BACKGROUND
  To assess the clinical outcome of chemoradiotherapy with or without surgery for locally recurrent rectal cancer (LRRC) and to find useful and significant prognostic factors for a clinical situation.
  
  
  METHODS
  Between January 2001 and February 2009, 67 LRRC patients, who entered into concurrent chemoradiotherapy with or without surgery, were reviewed retrospectively. Of the 67 patients, 45 were treated with chemoradiotherapy plus surgery, and the remaining 22 were treated with chemoradiotherapy alone. The mean radiation doses (biologically equivalent dose in 2-Gy fractions) were 54.6 Gy and 66.5 Gy for the chemoradiotherapy with and without surgery groups, respectively.
  
  
  RESULTS
  The median survival duration of all patients was 59 months. Five-year overall (OS), relapse-free (RFS), locoregional relapse-free (LRFS), and distant metastasis-free survival (DMFS) were 48.9%, 31.6%, 66.4%, and 40.6%, respectively. A multivariate analysis demonstrated that the presence of symptoms was an independent prognostic factor influencing OS, RFS, LRFS, and DMFS. No statistically significant difference was found in OS (p = 0.181), RFS (p = 0.113), LRFS (p = 0.379), or DMFS (p = 0.335) when comparing clinical outcomes between the chemoradiotherapy with and without surgery groups.
  
  
  CONCLUSIONS
  Chemoradiotherapy with or without surgery could be a potential option for an LRRC cure, and the symptoms related to LRRC were a significant prognostic factor predicting poor clinical outcome. The chemoradiotherapy scheme for LRRC patients should be adjusted to the possibility of resectability and risk of local failure to focus on local control.
authors: Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors: Joo Ho
authors: JH
authors: Lee
authors: Dae Yong
authors: DY
authors: Kim
authors: Sun Young
authors: SY
authors: Kim
authors: Ji Won
authors: JW
authors: Park
authors: Hyo Seong
authors: HS
authors: Choi
authors: Jae Hwan
authors: JH
authors: Oh
authors: Hee Jin
authors: HJ
authors: Chang
authors: Tae Hyun
authors: TH
authors: Kim
authors: Suk Won
authors: SW
authors: Park
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