title: Chemoradiation in rectal squamous cell carcinoma: Bi-institutional case series.
abstract: OBJECTIVE
  Primary rectal squamous cell carcinoma (SCC) is an uncommon disease. Early reports stated that surgery is the most effective treatment. However, recent publications suggest conservative strategy with chemoradiation provides satisfactory results.
  
  
  METHODS
  We have retrospectively studied the medical charts of 23 patients treated for a rectal SCC in two teaching hospitals in France between 1992 and 2013. Twenty-one patients received an exclusive chemoradiotherapy (CRT) and two a pre-operative CRT followed by a planned surgery. Patients received pelvic irradiation with a dose ranging from 36-45 Gy followed by a boost of 15-23 Gy. Twenty-two patients received a concurrent chemotherapy.
  
  
  RESULTS
  After CRT, the rate of clinical complete response was 83%. With a median follow-up of 85 months, 5-year overall survival rate was 86%. Five patients presented with a relapse. The 5-year disease-free survival rate was 81%. The 5-year colostomy-free survival rate was 65%. Three patients (13%) presented with grade III-IV late rectal toxicity.
  
  
  CONCLUSIONS
  Although retrospective, this is the largest cohort of patients treated with CRT for a rectal SCC. Exclusive CRT could result in high local control rate and prolonged survival in rectal SCC patients with a high rate of organ preservation.
authors.affiliation: Department of Radiation Oncology, Tenon Hospital, Hôpitaux Universitaires Est Parisien, Pierre and Marie Curie Paris 6 University, Paris, France.
authors.forename: Gokoulakrichenane
authors.initials: G
authors.lastname: Loganadane
authors.affiliation: Department of Radiation Oncology, Besançon University Hospital, Besançon, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Servagi-Vernat
authors.affiliation: Department of Radiation Oncology, Tenon Hospital, Hôpitaux Universitaires Est Parisien, Pierre and Marie Curie Paris 6 University, Paris, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Schernberg
authors.affiliation: Department of Radiation Oncology, Tenon Hospital, Hôpitaux Universitaires Est Parisien, Pierre and Marie Curie Paris 6 University, Paris, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Schlienger
authors.affiliation: Department of Radiation Oncology, Tenon Hospital, Hôpitaux Universitaires Est Parisien, Pierre and Marie Curie Paris 6 University, Paris, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Touboul
authors.affiliation: Department of Radiation Oncology, Besançon University Hospital, Besançon, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Bosset
authors.affiliation: Department of Radiation Oncology, Tenon Hospital, Hôpitaux Universitaires Est Parisien, Pierre and Marie Curie Paris 6 University, Paris, France. Electronic address: florence.huguet@aphp.fr.
authors.forename: Florence
authors.initials: F
authors.lastname: Huguet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000401:mortality; D059186:Chemoradiotherapy, Adjuvant; D003125:Colostomy; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005602:France; D006785:Hospitals, University; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D016016:Proportional Hazards Models; D011829:Radiation Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000401:mortality; D050397:Radiotherapy, Intensity-Modulated; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Chemoradiation; Colostomy; Rectal cancer; Squamous cell carcinoma; Survival; Toxicity