title: Definitive high-dose radiotherapy with concurrent chemotherapy for locally advanced rectal cancer: A case report and literature review.
abstract: BACKGROUND
  Standard management for locally advanced rectal cancer (LARC) involves preoperative chemoradiotherapy (CRT) and radical surgery. However, this level of treatment may be unnecessary for a subgroup of LARC patients. Previous reports have shown that approximately 20% of LARC patients experience a complete tumor response to preoperative CRT. Post-CRT nonoperative management of these patients may prevent morbidities associated with radical surgery. To our knowledge, this case report firstly presents the favorable long-term outcomes of a LARC patient who underwent definitive aim CRT.
  
  
  METHODS
  The patient was 73 years' old, and staging workups revealed T3N2bM0 rectal adenocarcinoma. He agreed to receive CRT, but refused surgery. A radiotherapy (RT) dose of 64.8 Gy was prescribed, which was higher than conventional (50.4 Gy) preoperative aim RT. The regimen of concurrent chemotherapy was the same as that used in preoperative aim CRT: 2 cycles of 5-fluorouracil and leucovorin.
  
  
  RESULTS
  Three months after CRT completion, a complete tumor response was identified clinically. Colonoscopic biopsy after 1 year showed no tumor cells. This patient is alive after 4 years with no evidence of recurrence or severe toxicity.
  
  
  CONCLUSIONS
  The long-term outcomes of this case indicate the feasibility of definitive high-dose RT with concurrent chemotherapy for LARC.
authors.affiliation: Department of Radiology, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang Department of Radiation Oncology, Soonchunhyang University College of Medicine, Soonchunhyang University Hospital, Cheonan, Republic of Korea.
authors.forename: Min-Jeong
authors.initials: MJ
authors.lastname: Kim
authors.forename: Eun Seok
authors.initials: ES
authors.lastname: Kim
authors.forename: Seung-Gu
authors.initials: SG
authors.lastname: Yeo
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000188:drug therapy / Q000532:radiotherapy*; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D019583:Dose Fractionation, Radiation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000532:radiotherapy*; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents