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Effects of Preoperative Radiotherapy for $T_2,\;T_3$ Distal Rectal Cancer  

Kang Ki Mun (Department of Therapeutic Radiology, Gyengsang National University, College of Medicine)
Choi Byung Ock (Department of Therapeutic Radiology, The Catholic University of Korea, College of Medicine)
Jang Hong Seok (Department of Therapeutic Radiology, The Catholic University of Korea, College of Medicine)
Kang Young Nam (Department of Therapeutic Radiology, The Catholic University of Korea, College of Medicine)
Chai Gyu Young (Department of Therapeutic Radiology, Gyengsang National University, College of Medicine)
Choi Ihl Bohng (Department of Therapeutic Radiology, The Catholic University of Korea, College of Medicine)
Publication Information
Radiation Oncology Journal / v.20, no.3, 2002 , pp. 215-220 More about this Journal
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 $T_2,\;T_3$ 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 $T_2$ and 8 $T_3$ 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 peformed $4\~6$ 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 $N_1$ 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 $T_2\;T_3$ distal rectal cancer.
Keywords
Preoperative radiotherapy; Distal rectal cancer;
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