RESUMEN
<p><b>OBJECTIVE</b>To investigate the effect of preoperative radiotherapy or chemoradiotherapy on the sphincter preservation and local tumor control as well as survival for the patient with locally advanced middle-low rectal cancer.</p><p><b>METHODS</b>121 locally advanced middle-low rectal cancer patients were treated with preoperative radiotherapy or chemoradiotherapy followed by surgery after rest of 4 to 6 weeks. 103 of these patients who underwent radical surgery were finally included in this study. The irradiation regimen was: 40 Gy/4 - 5 weeks, whereas 57 of these 103 patients received concurrent chemotherapy of 5-Fu or Xeloda. Sphincter-preserving surgery was performed in 59 patients and abdominoperineal resection in 44 patients. The survival was estimated by Kaplan-Meier model, and the differences between groups were compared using Log rank test. Multivariate analysis was performed by Cox's model.</p><p><b>RESULTS</b>Ten patients (9.7%) achieved a complete pathological response (pCR) to preoperative radiotherapy or chemoradiotherapy. The sphincter preservation rate was 57.3%. The 3-year overall survival (OS) and disease free survival (DFS) was 66.3% and 59.5%, respectively. Univariate analysis showed that pCR and postoperative pTNM stage were prognostic factors affecting survival, whereas, only pTNM stage was an independent prognostic factor (P = 0.003) by multivariate analysis.</p><p><b>CONCLUSION</b>Neoadjuvant preoperative radiotherapy and chemoradiotherapy is effective in local tumor control and improving survival for locally advanced middle-low rectal cancer, which can raise the rate of sphincter-preserving surgery, and achieve comparable result to abdominoperineal resection.</p>
Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adenocarcinoma , Patología , Terapéutica , Protocolos de Quimioterapia Combinada Antineoplásica , Usos Terapéuticos , Capecitabina , Terapia Combinada , Desoxicitidina , Usos Terapéuticos , Fluorouracilo , Usos Terapéuticos , Estudios de Seguimiento , Estimación de Kaplan-Meier , Leucovorina , Análisis Multivariante , Terapia Neoadyuvante , Aceleradores de Partículas , Cuidados Preoperatorios , Radioterapia de Alta Energía , Métodos , Neoplasias del Recto , Patología , Terapéutica , Estudios RetrospectivosRESUMEN
0.05).ConclusionThe neoadjuvant radiochemotherapy can improve the sphincter-saving rate,probably can improve the resection rate and reduce the recurrence rate for the middle-lower rectal carcinoma.