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The Journal of the Korean Society for Therapeutic Radiology and Oncology 2002;20(3): 215-220. |
| Effects of Preoperative Radiotherapy for T2, T3 Distal Rectal Cancer |
| Ki Mun Kang, Byung Ock Choi, Hong Seok Jang, Young Nam Kang, Gyu Young Chai, Ihl Bohng Choi |
1Department of Therapeutic Radiology, Gyengsang National University, College of Medicine, Jinju, Korea. jks92@nongae.gsnu.ac.kr
2Department of Therapeutic Radiology, The Catholic University of Korea, College of Medicine, Seoul, Korea. |
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| ABSTRACT |
PURPOSE:
Preoperative radiotherapy has been used to induce tumor regression and allow complete resection of rectal cancer with a sphincter preservation surgery. This study was performed to determine the effectiveness of preoperative radiotherapy for T2, T3 distal rectal carcinoma.
MATERIALS AND METHODS:
From November 1995 to June 1997, fifteen patients with invasive distal rectal cancer were treated with preoperative radiotherapy followed by sphincter preservation surgery. Classification by preoperative T stage consisted of 7 T2 and 8 T3 tumors. Radiation therapy was delivered with 6 MV and 15 MV linear accelerator, at 1.8 Gy fractions for 5 days per week. Total radiation doses were 45 Gy to 50.4 Gy (median : 50.4 Gy). Sphincter preservation surgery was performed 4~6 weeks after the completion of radiotherapy. Median follow-up was 22 months (range : 16~37 months).
RESULTS:
One patient (6.7%) had a complete pathologic response. Comparing the stage at the diagnostic workup with the pathologic stage, tumor downstaging of T stages occurred in 11 of 15 patients (73.3%) and N1 stages occurred in 2 of 5 patients (40%). No patient developed progressive disease undergoing treatment. Two patients suffered local recurrence at 7 and 20 months, and one a distant metastasis at 30 months. No grade 3 or 4 toxicity was observed.
CONCLUSION:
Our experience suggests that preoperative radiotherapy followed by sphincter preservation surgery is well tolerated, and can significantly reduce the tumor burden for T2, T3 distal rectal cancer. |
| Key Words:
Preoperative radiotherapy, Distal rectal cancer |
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