title: Long Term Outcomes of Preoperative versus Postoperative Concurrent Chemoradiation for Locally Advanced Rectal Cancer: Experience from Ramathibodi Medical School in Thailand.
abstract: OBJECTIVE
  The study analyzed and compared the long term outcome in locally advanced rectal cancer treated with preoperative and postoperative concurrent chemoradiation (CCRT).
  
  
  METHODS
  A retrospective review of 105 patients with stage T3-T4 or regional lymph node positive adenocarcinoma of rectum treated with preoperative or postoperative CCRT at Ramathibodi Hospital during 2005 to 2010 was performed. The results of treatment were reported with 5-year overall survival (OS), 5- year locoregional recurrence free survival (LRFS), and toxicity according to preoperative versus postoperative concurrent chemoradiation (CCRT) groups.
  
  
  RESULTS
  Among 105 patients, 34 (32%) were treated with preoperative CCRT and 71 (68%) with postoperative CCRT. At the median follow-up time of 50.5 months (range 2-114 months), five-year OS and LRFS of all patients were 87% and 91.6%, respectively. The study found no difference in 5-year OS (81.7% vs 89.2 %) or LRFS (83.4% vs 95.1%) between preoperative versus postoperative CCRT. Seven cases of loco-regional recurrence were diagnosed, 4 (11.8%) after preoperative CCRT and 3 (4.2%) after postoperative CCRT. The recurrent sites were anastomosis in all patients. There was no significant factor associated with outcome after univariate and multivariate testing. Grade 3 or 4 acute and late complications were low in both preoperative and postoperative CCRT groups.
  
  
  CONCLUSIONS
  Locally advanced rectum cancer patients experience good results with surgery and adjuvant concurrent chemoradiation.
authors.affiliation: Radiation and Oncology Unit, Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand E-mail : putipun.pua@mahidol.ac.th.
authors.forename: Pichayada
authors.initials: P
authors.lastname: Darunikorn
authors.forename: Putipun
authors.initials: P
authors.lastname: Puataweepong
authors.forename: Mantana
authors.initials: M
authors.lastname: Dhanachai
authors.forename: Somjai
authors.initials: S
authors.lastname: Dangprasert
authors.forename: Thiti
authors.initials: T
authors.lastname: Swangsilpa
authors.forename: Chomporn
authors.initials: C
authors.lastname: Sitathanee
authors.forename: Chuleeporn
authors.initials: C
authors.lastname: Jiarpinitnun
authors.forename: Poompis
authors.initials: P
authors.lastname: Pattaranutaporn
authors.forename: Keeratikan
authors.initials: K
authors.lastname: Boonyawan
authors.forename: Pichai
authors.initials: P
authors.lastname: Chansriwong
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000069287:Capecitabine / Q000008:administration & dosage; D059248:Chemoradiotherapy / Q000401:mortality*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011184:Postoperative Period; D057234:Preoperative Period; D011379:Prognosis; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D012577:Schools, Medical; D015996:Survival Rate; D013785:Thailand; D013997:Time Factors
chemical_list: D000069287:Capecitabine; D002955:Leucovorin; D005472:Fluorouracil