Preoperative Radiotherapy for Resectable Adenocarcinoma of the Rectum
RA Zlotecki,1 WM Mendenhall,1
EM Copeland III2
1Department of Radiation Oncology, 2Department of Surgery, University of Florida College of Medicine, Gainesville, Florida, USA
Objective: To evaluate recurrence and survival rates in patients with
resectable rectal adenocarcinoma treated with preoperative radiotherapy.
Patients and Methods: Two hundred and ten patients with resectable rectal adenocarcinoma treated with preoperative radiotherapy and surgery were seen for a minimum 5 years of follow-up. No patient received adjuvant chemotherapy.
Results: Local control was 94% at 5 years and 90% at 10 years. Absolute and cause-specific survival rates were 62% and 72% at 5 years, and 40% and 63% at 10 years, respectively. Delayed wound healing and postoperative infections were the most common acute treatment-related side effects, each occurring in 17% of cases. Small bowel obstruction occurred in 4% of patients. Anastomotic leak occurred in 3 (12%) of the 25 patients in whom low anterior resection was performed.
Conclusion: This data demonstrates that moderate-dose preoperative radiotherapy increases the likelihood of local control for resectable rectal adenocarcinomas and may thus improve survival. The risk of significant treatment-related complications with this approach is low. (HK Coll Radiol 2002;5:88-96)
Key Words: Radiotherapy, Rectal neoplasms, Surgery
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