Turkish Journal of Oncology Turkish Society for Radiation Oncology
Article Open Access Volume 23 · Issue 4 · 2008 pp. 163–171

Preoperative radiotherapy with concomitant fluoropyrimidine-based chemotherapy for resectable locally advanced rectal cancer

Beste Melek ATASOY1, Faysal DANE2, Hale ÇAĞLAR1, Evrim TEZCANLI3, Asım CİNGİ4, Ufuk ABACIOĞLU1, Serdar TURHAL2, Cumhur YEĞEN4
1 Marmara Üniversitesi Tıp Fakültesi Radyasyon Onkolojisi Anabilim Dalı, İstanbul, Turkey
2 Marmara Üniversitesi Tıp Fakültesi İç Hastalıkları Anabilim Dalı Tıbbi Onkoloji Bilim Dalı, İstanbul, Turkey
3 Acıbadem Kozyatağı Hastanesi Radyasyon Onkolojisi Kliniği, İstanbul, Turkey
4 Marmara Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı, İstanbul, Turkey
Published: 2008 Pubmed: 80085 Article ID: 704
Abstract
OBJECTIVES

To investigate the treatment results and tumor and patient characteristics in patients with resectable locally advanced rectum cancer (LARC) who were treated with preoperative chemoradiation.


METHODS

T3/T4 rectal adenocarcinoma patients (n=50) were evaluated retrospectively. Tumors were located within 5 cm of the anal verge in 60% of patients. Twenty-four (48%) of the patients had positive lymph nodes. Pelvic radiotherapy was administered with a median dose of 45Gy in linear accelerator. Concurrent fluoropyrimidine was given orally (n=18) or intravenously (n=32).


RESULTS

Median follow-up was 17 months. Two-year local control, disease- free survival and overall survival were 93.6%, 90.3% and 93.3%, respectively. Sphincter-preserving surgery rate was 43% for distal tumors. Downstaging was observed in 35% with seven ypT0N0 cT4 (p=0.01), lymphovascular-perineural invasion (p=0.01) and pN+ (p=0.02) were predictive for a worse prognosis. Grade 3 toxicity was observed in 8% of patients.


CONCLUSION

Preoperative chemoradiotherapy demonstrated similar benefit regarding sphincter preservation with that of standard postoperative multimodality therapies in LARC patients.

Keywords: Chemoradiotherapy; neoadjuvant treatment; rectal cancer; Turkish patients

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