| Treatment Results of Preoperative Radiotherapy Alone vs. Preoperative Radiotherapy and Chemotherapy in Locally Advanced Rectal Cancer |
| Jae Sung Kim, Seoung Ho Park, Moon June Cho, Wan Hee Yoon, Jin Sun Bae, Hyun Yong Jeong, Kyu Sang Song |
1Department of Therapeutic Radiology, Chungnam National University Hospital, Taejon, Korea.
2Department of General Surgery, Chungnam National University Hospital, Taejon, Korea.
3Department of Internal Medicine, Chungnam National University Hospital, Taejon, Korea.
4Department of Pathology, Chungnam National University Hospital, Taejon, Korea. |
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| ABSTRACT |
PURPOSE:
To assess the efficacy and toxicity of the preoperative radiotherapy with or without chemotherapy in locally advanced rectal cancer.
METHODS:
Forty three Patients (clinically diagnosed stages above or equal to Astler-Coller stage B2 without distant metastasis) were assigned to preoperative radiotherapy alone arm (n=16) or combined preoperative radiotherapy and chemotherapy arm (n=27). Preoperative radiotherapy of 4500 cGy to whole pelvis +/- 540 cGy boost to primary site and concurrent chemotherapy of 2 cycles of 5-FU (500 mg/m2) and leucovorin (20 mg/m2) were used. Fifteen patients of preoperative radiotherapy alone arm and 19 of combined arm received surgical resection after preoperative treatment.
RESULTS:
During the preoperative treatment, no significant complication was developed in both groups. Pathologic results were as follows; complete remission 1, B1 1, B2 6, C1 2, C2 5 in preoperative radiotherapy alone arm and complete remission 2, B1 8, B2 4, C2 3 D2 in combined arm.
Postoperative complications were delayed perineal would healing in three patients, intestinal obstruction in three patients (one managed by conservative medical treatment, two by surgical treatment).
CONCLUSION:
The combined preoperative radiotherapy and chemotherapy arm was more effective in pathological response and lymph node negativity rate that the preoperative radiotherapy alone arm. Both the preoperative radiotherapy alone arm and the combined arm were generally well tolerated and did not result in an increased postoperative morbidity. |
| Key Words:
Preoperative radiotherapy, Rectal cancer |
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