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J Korean Soc Ther Radiol Oncol > Volume 16(1); 1998 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 1998;16(1): 35-41.
Comparison of Postoperative Adjuvant Radiation therapy alone vs. Chemoradiotherapy in Adenocarcinoma of the Rectum
John Jihoon Lim, Won Park, Jinsil Seong, Chang Ok Suh, Gwi Eon Kim, Jin Sik Min, Hyun Cheol Chung, Jae Kyung Roh, Byung Soo Kim
1Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
2Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
3Department of Hemato-Oncology, Yonsei University College of Medicine, Seoul, Korea.
4Department of Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
ABSTRACT
PURPOSE:
To investigate the role of adjuvant chemoradiotherapy in adenocarcinoma of the rectum, we retrospectively compared the treatment results between postoperative adjuvant radiotherapy alone and combined chemoradiotherapy. MATERIAL AND
METHODS:
From October 1989 to May 1994, 141 patients with rectal carcinoma were treated by postoperative adjuvant therapy in Yonsei Cancer Center. Sixty eight patients were treated by radiation therapy alone. Seventy three patients were treated by combined chemoradiotherapy. Radiation therapy was delivered with 10 MV linear accelerator, 180cGy fraction/5 days per week. Total radiation doses were 5400cGy in the postoperative radiotherapy alone group. Three to twelve cycles of Fluorouracil (mean dose 393.9mg/m2) with Leucovorin (20mg/m2) and 5040cGy of radiation were delivered in the combined chemoradiotherapy group. Third and 4th cycle of chemotherapy were administrated during the radiation treatment in the combined group. The median follow up was 38 months with a range of 3 to 81 months.
RESULTS:
The 5 year overall survival rate of radiation alone group and combined group were 60.1% and 66.3%, respectively. The 5 year disease free survival rate of radiation alone group and combined group were 54.2% and 65.5%, respectively. There was no significant difference of overall survival and disease free survival between RT alone group and combined group (P<0.05). But the 5 year Local failure free survival rate of combined group was significantly better than radiotherapy alone group (65.8% vs. 50.3%, P=0.04).
CONCLUSION:
There was no significant difference in overall survival, disease free survival, and distant metastasis free survival between postoperative adjuvant radiotheray alone group and combinded chemoradiotherapy group. Only the Local failure free survival rate was superior in the combined treatment group. These results confirm the radiosensitizing effect of the chemotherapeutic agent in the combined chemoradiotherapy treatment.
Key Words: Rectal cancer, Surgery, Radiation therapy, Chemoradiotherapy
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