Prospective randomized trial of surgery combined with preoperative and postoperative radiotherapy for rectal carcinoma
- Author:
Xiaozhi ZHANG
1
Author Information
1. Oncology Center
- Publication Type:Journal Article
- Keywords:
Operation;
Radiotherapy;
Rectal carcinoma
- From:Academic Journal of Xi'an Jiaotong University
;20(2):134-137
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To assess the effect of surgery combined with preoperative and postoperative radiotherapy ("sandwich" treatment) in rectal carcinoma. Methods: From October 1990 to January 2002, 260 patients with stage II (117 patients) and stage III (143 patients) rectal carcinoma were randomly divided into three groups: "sandwich" group (92 patients, group A), postoperative radiotherapy group (98 patients, Group B) and operation group (70 patients, Group C). The preoperative accelerated hyperfractionation (15 Gy/6f/3d) was given for "sandwich" group which was followed by conventional postoperative fractionation (DT 35-40 Gy/3.5-4 weeks). Patients in Group B were given postoperative radiotherapy (DT 50 Gy/5 weeks). Patients treated with surgery alone served as control. Results: The local recurrence rates of Group A, B and C were 5.4%(5/92), 16.3%(16/98) and 64.3%(45/70), respectively (χ2 = 5.726, P = 0.017); and the distant metastasis rates were 6.5%(6/92), 28.6%(28/98) and 31.4%(22/70), respectively (χ2 = 15.703, P = 0.001). The 3-year survival rate was 86.9%(80/92), 62.2% (61/98) and 51.4%(36/70), respectively (χ2 = 15.141, P = 0.001). The 5-year survival rate was 68.5%(63/92), 54.1%(54/98) and 41.4%(29/70), respectively (χ2 = 4.218, P = 0.04). The I and II grades of radiation enterocolitis in Group A and Group B were 7.6%(7/92) and 6.1%(6/98), respectively (χ2 = 0.164, P = 0.685). Conclusion: Surgery combined with preoperative and postoperative radiotherapy can improve the survival rate and reduce the local recurrence rate in rectal carcinoma patients with stage Duke's B (II) and C (III).
