Concurrent chemoradiotherapy in the treatment of locally recurrent rectal cancer.
OBJECTIVE
Long course concurrent chemoradiotherapy provides potential tumor downstaging. When local recurrent rectal cancer without distant metastases is diagnosed, a potentially curative resection can be performed. The aim of this study was to assess the outcome of concurrent chemoradiotherapy in treating isolated local recurrent rectal cancer.


METHODS
Patients (n=102) with isolated local recurrent rectal cancer within the pelvis were scheduled for concurrent chemoradiotherapy, consisting of pelvic irradiation with a total dose of 50.4 Gy in 28 fractions. Chemotherapy was administered concurrently and included 85 mg/m2 oxaliplatin by venous infusion over 2 h on day 1, followed by 1,200 mg*m-2*day-1 of continuous venous infusion for 2 days. This regimen was repeated every 2 weeks for 6 cycles. The overall survival rate, responses, disease-free interval and toxicities were assessed.


RESULTS
A total of 96 patients completed planned concurrent chemoradiation. Complete clinical responses were found in 13 of the 96 patients (14%), partial responses in 59 (61%), stable disease in 21 (22%) and disease progression in 3 (3%). The overall survival and disease-free survival rates in all the 96 patients were 45% and 14%, respectively.


CONCLUSIONS
The treatment of locally recurrent rectal cancer is complicated. Concurrent chemoradiation can increase disease-free survival and overall survival by increasing complete resection rate of locally recurrent tumors and even complete response of the tumors. Ongoing treatment strategies aim to enhance response rates and to accurately assess the extent of local recurrent tumor response to concurrent chemoradiation.
Division of Colon and Rectal Surgery, Chang Gung University College of Medicine, Taiwan. kproct@adm.cgmh.org.tw
Yau-Tong
YT
You
Jinn-Shiun
JS
Chen
Jeng-Yi
JY
Wang
Reiping
R
Tang
Chung-Rong
CR
Changchien
Jy-Ming
JM
Chiang
Chien-Yuh
CY
Yeh
Pao-Shiu
PS
Hsieh
Wen-Sy
WS
Tasi
Hsin-Yuan
HY
Hung
Jeng-Fu
JF
You
Sum-Fu
SF
Chiang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D012004:Rectal Neoplasms / Q000401:mortality / Q000628:therapy*