Effects of Preoperative Radiotherapy for T2, T3 Distal Rectal Cancer.
- Author:
Ki Mun KANG
1
;
Byung Ock CHOI
;
Hong Seok JANG
;
Young Nam KANG
;
Gyu Young CHAI
;
Ihl Bohng CHOI
Author Information
1. Department of Therapeutic Radiology, Gyengsang National University, College of Medicine, Jinju, Korea. jks92@nongae.gsnu.ac.kr
- Publication Type:Original Article
- Keywords:
Preoperative radiotherapy;
Distal rectal cancer
- MeSH:
Classification;
Follow-Up Studies;
Humans;
Neoplasm Metastasis;
Particle Accelerators;
Radiotherapy*;
Rectal Neoplasms*;
Recurrence;
Tumor Burden
- From:The Journal of the Korean Society for Therapeutic Radiology and Oncology
2002;20(3):215-220
- CountryRepublic of Korea
- Language:Korean
-
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.