2Marmara Üniversitesi Tıp Fakültesi İç Hastalıkları Anabilim Dalı Tıbbi Onkoloji Bilim Dalı, İstanbul, Turkey
3Acıbadem Kozyatağı Hastanesi Radyasyon Onkolojisi Kliniği, İstanbul, Turkey
4Marmara Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı, İstanbul, Turkey 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.