Original Article · Originalarbeit

Preoperative Radio-Chemotherapy Treatment in Locally Advanced Rectal Carcinoma. Results of 8-Year Follow-Up
W. Mermershtain^a; A. Gluzman^a; I. Gusakova^a; S. Walfish^b; Y. Cohen^a; S. Ariad^a

^aDepartment of Oncology, ^bDepartment of Surgery, Soroka University Medical Center, Faculty of Health Science, Ben Gurion University of the Negev, Beer Sheva, Israel

Onkologie 2005;28:267-269
(DOI: 10.1159/000085062)

  Summary

Background: Preoperative radio-chemotherapy (RCT) may play an important role in decreasing local recurrence and possibly improving survival for patients with advanced rectal carcinoma. Patients and Methods: Between 1995 and 1998 we treated 30 patients (pts) (median age 61.5 years) with advanced low rectal cancer. Radiotherapy was administered using a 10-MV linear accelerator delivering a total dose of 45 Gy to the pelvis over 5 weeks. 5-FU (500 mg/m2/d i.v.) was given concomitantly on days 1-3 and 29-31. Surgery was performed 2-4 weeks after RCT and included abdomino-perineal resection (APR) in 15 pts, anterior resection in 11 pts, transanal resection in 1 pt, and explorative laparotomy in 1 pt; 2 pts refused surgery. Results: There were no serious toxicities associated with RCT. Mild to moderate transient radiation dermatitis was noted in 3 pts, and grade II diarrhea in 4 pts. Postoperative pathologic staging was as follows: no tumor found (CR): 4 pts, MAC B1 (T2N0M0): 5 pts, MAC B2 (T3N0M0): 17 pts, B3 (vaginal involvement): 1 pt, MAC C2 (T3N1M0): 2 pts, and MAC D: 1 pt. Necrosis and/or fibrosis was noted as a prominent histopathologic feature. Conclusion: Preoperative RCT in this series of 30 pts with advanced rectal cancer was well tolerated and associated with a high response rate (13% CR, 17% PR, 57% NC). 5-year overall survival was 70%, and 8-year survival was 58%.

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