Preperative Radiotherapy Concurrent with Chemotherpy for Locally Advaced Rectal Cancer

Abstract

”Purpose: This study is to present the rates of tumor down-staging and sphincter-preservation with pre-operative concurrent chemo-radiation therapy (CCRT) in locally advanced rectal cancer Methods and Materials: Between June1999 and February 2002, twenty-two patients with advanced rectal cancer were treated with preoperative CCRT, followed by surgical resection of disease, The patient population consisted of 16 males and 6 females that had a median age of 61 year (range 28 to 76 years). Most of patients received high dose 5-Fluorouracil (5-FU) and Leucovorin, concurrent with pelvic irradiation 50.40Gy(45-50.4 Gy) in 28 fractions over 5.5 weeks. The median interval between completion of radiotherapy and surgery was 6 weeks (range 1-11.7 weeks). The retreatment and post-treatment stages were compared and rates of sphincter preservation were evaluated. Results: Twelve (55%) out of 22 patients achieved tumor downstaging, and 3 (14%) patients had pathologic complete remission. Five patients remained the same stage as pretreatment clinical stage. Two patients had clinical N1 disease but pathologic N2 stage. Sphincter- preserving surgery can achieve in 18(82%) patients. Conclusion: Pre-operative CCRT followed by surgery can be effective for tumor shrink-age, tumor downstaging, and achieving sphincter preservation in most of patients.”