Efficacy observation of surgical operation combined with neoadjuvant concurrent chemoradiotherapy before operation for middle and lower rectal carcinoma in phase II and III

Abstract

Objective To explore the application value of surgical operation combined with neoadjuvant chemoradiation therapy for rectal carcinoma in phase Ⅱ and Ⅲ and to evaluate the effect of surgical resection. Methods A retrospective analysis was performed from January 2012 to January 2017, including 70 cases of middle and lower rectal carcinoma in phase Ⅱ and Ⅲ in the First Affiliated Hospital of Hebei North University. Neoadjuvant concurrent chemoradiotherapy before operation was applied. Neoadjuvant radiotherapy: total dose 50 Gy, 2.0 Gy for once, 5 times per week, 5 weeks in total, the radiation field 5 wild for pelvic irradiation. Neoadjuvant chemotherapy: XELOX (oxaliplatin, capecitabine)/ FOLFOX (oxaliplatin, leucovorin, 5-fluorouracil) was used for synchronous chemotherapy. After radiotherapy, the patients received surgery in 6-8 weeks. All the operations were performed according to the total mesorectum excision (TME) specification. Results A total of 70 patients underwent neoadjuvant concurrent chemoradiotherapy. The adverse effect rate was 15.71% (11/70) of grade Ⅰ and 7.14% (5/70) of grade Ⅱ. No grade Ⅲ and Ⅳ adverse reactions occurred. The tumor stage of 94.29% (66/70) patients reduced. The TNM stage of the postoperation was decreased compared with that before neoadjuvant chemoradiotherapy (χ2= 7.846, P < 0.05). Tumor resection rate was 94.29% (66/70). Conclusion Surgical operation combined with neoadjuvant concurrent chemoradiotherapy before operation for middle and lower rectal carcinoma in phase Ⅱ and Ⅲ has a favorable efficacy and safety, which can alleviate the tumor staging and increase the eradication rate of tumors. Key words: Rectal neoplasms; Chemotherapy, adjuvant; Radiotherapy, adjuvant; Total mesorectal excision