Observation on the effect of preoperative radiotherapy on the local advanced middle and low rectal cancer

Abstract

Objective To discuss the treatment efficacy and radiotherapy side effects of the preoperative long-course radiochemotherapy and preoperative short-course radiotherapy. Methods 64 patients with local advanced middle and low rectal cancer who got the treatment from April 2004 to April 2010 were analyzed retrospectively. 40 patients got the preoperative long-course radiochemotherapy under the dose of DT 45-50 Gy/25 F, 1.8-2.0 Gy/F, 5 F/W, combining with the synchronous capecitabine chemotherapy (1 650 mg/m2, 2 F/d, d1-14/d21-35), and accepted operation 4-6 weeks after the radiotherapy. The rest 24 patients underwent the preoperative short-course radiotherapy under the dose of DT 25 Gy/5 F, 5 Gy/F, 5 F/W, and got the operation in 2 weeks after the radiotherapy. Results The radical and anus reservation rates in preoperative long-course radiochemotherapy group [85.0 % (34/40), 65.0 % (26/40)] were higher than those in preoperative short-course radiotherapy group [58.3 % (14/24), 33.3 % (8/24)] (χ2 = 5.689, P= 0.019; χ2 = 6.040, P= 0.041). There were no significant differences between the two groups on the index of remission rates, radiation injury, surgical complications, and overall survival rate of 1, 3, 5 years (all P> 0.05). Conclusions The remission rate and overall survival time between the preoperative long-course radiochemotherapy group and preoperative short-course radiotherapy have no significant difference. But the preoperative long-course radiochemotherapy may improve the anus reservation rate and the radical resection rate, without increasing the radiation injury and surgical complications. Key words: Rectal neoplasms; Radiotherapy; Colorectal surgery