ABSTRACT
This study included 30 patients with rectal carcinoma with either border line respectability or not suitable for primary sphincter sparing surgery. Performance status >/60, adequate bone marrow reserve and adequate hepatic and renal functions. All patients had been staged by radiological studies and endoscopies. All patients were treated by combined chemo-radiation; radiotherapy with dose of 45 Gy in 25 fractions over 5 weeks, chemotherapy with 5-flurouracil 500 mg/m2 i.v. infusion over 2 hours and leucovorin immediately before radiation setting for first 5 days of the first week and the first 5 days of the last week of radiation. Patients were evaluated 4-6 weeks after treatment. Operable patients were subjected to abdominoperineal resection [APR] or low anterior resection [AR]. Toxicity was evaluated using WHO Common Toxicity Criteria. In conclusion, preoperative chemo-radiotherapy is an effective treatment in inducing down-staging of locally advanced rectal cancer patients and enhances curative resection and sphincter preserving procedures