title: Short-term effects of neoadjuvant chemoradiation therapy on anorectal function in rectal cancer patients: a pilot study.
abstract: BACKGROUND
  Neoadjuvant chemoradiation therapy followed by curative surgery has gained acceptance as the therapy of choice in locally advanced rectal cancer. However, deterioration of anorectal function after long-course neoadjuvant chemoradiation therapy combined with surgery for rectal cancer is poorly defined. The aim of this study was to evaluate the physiological and clinical change of anorectal function after neoadjuvant chemoradiation therapy for rectal cancer.
  
  
  METHODS
  We analyzed 30 patients on whom preoperative anorectal manometry data were available both before and after chemoradiation from October 2010 to September 2011. All patients underwent long-course neoadjuvant chemoradiation therapy. We compared manometric parameters between before and after neoadjuvant chemoradiation therapy.
  
  
  RESULTS
  Of 30 patients, 20 were males and 10 females. The mean age was 64.9 ± 9.9 years (range, 48-82). Before nCRT, the rectal compliance was higher in patients with ulceroinfiltrative type (P = 0.035) and greater involvement of luminal circumference (P = 0.017). However, there was the tendency of increased rectal sensory threshold for desire to defecate when the patient had decreased circumferential ratio of the tumor (P = 0.099), down-graded T stage (P = 0.016), or reduced tumor volume (P = 0.063) after neoadjuvant chemoradiation.
  
  
  CONCLUSIONS
  Neoadjuvant chemoradiation therapy did not significantly impair overall sphincter function before radical operation. The relationship between tumor response of chemoradiation and sensory threshold for desire to defecate may suggest that neoadjuvant chemoradiation may be helpful for defecatory function as well as local disease control, at least in the short-term period after the radiation in locally advanced rectal cancer patients.
authors: Department of Surgery, St, Vincent Hospital, The Catholic University of Korea, Suwon, Korea. hmcho@catholic.ac.kr.
authors: Bong-Hyeon
authors: BH
authors: Kye
authors: Hyung-Jin
authors: HJ
authors: Kim
authors: Jun-Gi
authors: JG
authors: Kim
authors: Sung-Hwan
authors: SH
authors: Kim
authors: Byoung-Yong
authors: BY
authors: Shim
authors: Nan-Sook
authors: NS
authors: Lee
authors: Hyeon-Min
authors: HM
authors: Cho
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000187:drug effects / Q000528:radiation effects; D059248:Chemoradiotherapy / Q000009:adverse effects*; D003187:Compliance; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects*; D010865:Pilot Projects; D012004:Rectal Neoplasms / Q000628:therapy*; D012007:Rectum / Q000187:drug effects / Q000528:radiation effects; D012684:Sensory Thresholds / Q000187:drug effects / Q000528:radiation effects
references: Br J Surg. 1998 Aug;85(8):1029-35
references: 9717992
references: Int J Colorectal Dis. 1997;12(2):82-7
references: 9189776
references: Lancet. 1986 Jun 28;1(8496):1479-82
references: 2425199
references: Dis Colon Rectum. 1997 Jun;40(6):693-7
references: 9194464
references: Dis Colon Rectum. 2010 Apr;53(4):445-9
references: 20305445
references: World J Surg. 2011 Aug;35(8):1918-24
references: 21519972
references: Int J Radiat Oncol Biol Phys. 1996 Jul 15;35(5):1003-10
references: 8751409
references: Tech Coloproctol. 2004 Nov;8 Suppl 1:s205-7
references: 15655624
references: Dis Colon Rectum. 1994 Dec;37(12):1228-31
references: 7995148
references: Br J Surg. 1985 Nov;72(11):875-8
references: 4063752
references: N Engl J Med. 2004 Oct 21;351(17):1731-40
references: 15496622
references: Int J Colorectal Dis. 1993 Sep;8(3):167-9
references: 8245674
references: Am J Gastroenterol. 1988 Oct;83(10):1140-4
references: 3421224
references: Dis Colon Rectum. 1998 May;41(5):543-9; discussion 549-51
references: 9593234
references: Colorectal Dis. 2003 Sep;5(5):458-64
references: 12925081
references: Radiother Oncol. 1999 Sep;52(3):239-43
references: 10580870
references: Dis Colon Rectum. 2006 Jan;49(1):12-9
references: 16292664
references: Dis Colon Rectum. 1992 Aug;35(8):757-61
references: 1643999
references: Clin Oncol (R Coll Radiol). 2005 Sep;17(6):469-77
references: 16149292
references: Arch Surg. 2003 Mar;138(3):257-61
references: 12611569