Annals of Surgical Oncology

, Volume 7, Issue 1, pp 38–44

Preoperative Combined Radiotherapy and Chemotherapy for Middle and Lower Rectal Cancer: Preliminary Results

  • Salvatore Pucciarelli
  • Maria Luisa Friso
  • Paola Toppan
  • Adriano Fornasiero
  • Sandro Carnio
  • Elisabetta Marchiori
  • Mario Lise
Original Paper

DOI: 10.1007/s10434-000-0038-5

Cite this article as:
Pucciarelli, S., Friso, M.L., Toppan, P. et al. Ann Surg Oncol (2000) 7: 38. doi:10.1007/s10434-000-0038-5

Abstract

Background: Adjuvant treatment for rectal cancer is still controversial. This study reports on overall survival and disease-free survival, toxicity, downstaging, and surgical morbidity in rectal cancer patients who received combined chemoradiation therapy followed by curative surgery.

Methods: Between 1993 and 1998, 51 patients (31 males and 20 females; median age, 60 years; range, 33–73 years) underwent chemoradiation therapy followed by radical surgery for middle and lower rectal adenocarcinoma. Criteria for giving preoperative radiotherapy (total 45 Gy in 25 fractions of 1.8 Gy/day for 5 weeks) and chemotherapy (5-fluorouracil 350 mg/m2/day and leucovorin 10 mg/m2/day, bolus on days 1–5 and 29–33) were an age younger than 75 years; an Eastern Cooperative Oncology Group performance status score of 0 to 2; and clinical preoperative stage II–III. Forty-three low anterior and eight abdominoperineal resections were performed. Median follow-up time was 29 (range, 3–63) months.

Results: Although grade 3 to 4 toxicity occurred in 14 cases (27.4%), all patients completed the planned adjuvant therapy. At pathology, a complete response was found in eight (15.7%) cases. Of the remaining 43 cases, 22 were stage I, 12 were stage II, and 9 were stage III. Five-year actuarial disease-free survival and overall survival rates were 86.4% and 85.5%, respectively. Whereas no local recurrences were found, 4 patients had distant metastases. Three patients died (1 of cancerrelated causes), 45 are alive and disease free, and 3 are alive with disease.

Conclusions: The combined preoperative chemoradiation approach used by us seems to improve the disease-free survival and overall survival of selected patients with rectal cancer. However, a longer follow-up time is required to confirm these preliminary results.

Keywords

Rectal cancer Surgery Radiotherapy Chemotherapy Adjuvant treatment 

Copyright information

© The Society of Surgical Oncology, Inc. 2000

Authors and Affiliations

  • Salvatore Pucciarelli
    • 1
    • 4
  • Maria Luisa Friso
    • 2
  • Paola Toppan
    • 1
  • Adriano Fornasiero
    • 3
  • Sandro Carnio
    • 1
  • Elisabetta Marchiori
    • 1
  • Mario Lise
    • 1
  1. 1.Clinica Chirurgica II, Dipartimento di Scienze Oncologiche e ChirurgicheUniversità di PadovaPadovaItaly
  2. 2.Divisione di RadioterapiaPadovaItaly
  3. 3.Divisione di Oncologia MedicaPadovaItaly
  4. 4.Dipartimento di Scienze Oncologiche e ChirurgicheSezione di Clinica Chirurgica II, Policlinico, VI PianoPadovaItaly

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