Results of Short Term Radiotherapy Followed by Radical Surgery for Rectal Cancer: A Long-Term Unicenter Observational Study

Abstract

IntroductionShort-term radiotherapy (STR) for rectal cancer (RC) has rarely been used in Spain. The aim of the present study is to describe oncological results after RTC and surgery for RC. MethodsThis is a retrospective analysis of a consecutive series of patients treated with STR and surgery for RC (1999–2012). Epidemiological data, staging, complications of STR, STR-surgery interval, surgical approach, rate of anastomotic/perineal wound dehiscence, and pathological data (regression degree and staging) were collected. Global survival, disease free survival, local recurrence rate and incidence of toxicity, response and complications of combined treatment are reported. ResultsOf 1229 patients treated, 209 patients received STR and surgery. The median follow-up was 6.2 years. Mean age was 68 years and 66% of the patients were men. A total of 88% were cT3-4 and 44% cN+17 (8.1%) patients had resectable synchronous metastases. Acute and chronic toxicity due to STR was <5%. In 75% of the cases the STR-surgery interval was <15 days, and in 9% >4 weeks. Seven patients (3.3%) presented complete response. Nine (4.3%) patients presented a local recurrence rate. Global survival at 5, 10 and 15 years was 67.8%, 49.2% and 37.5%, respectively. Disease free survival at 5, 10 and 15 years was 66.1%, 47.1% and 33%, respectively. ConclusionsThe results compare favorably with multicentric historical series. STR offers certain advantages that could be increased by increasing the STR-surgery interval and/or interspersed with sequential chemotherapy.