Résumé
Following potentially curative resection, the locoregional failure and the distant relapse, remain high. Consequently, adjuvant chemo and /or radiotherapy programs have been initiated. In the present study, 72 patients with stages II and III adenocarcinoma of the rectum and rectosigmoid were treated by radical surgery, and were divided at random into three equal groups: group I: treated by adjuvant radiotherapy alone, group II: treated by adjuvant chemotherapy alone for six cycles, and group III: treated by adjuvant three cycles of chemotherapy, then radiotherapy, and thereafter three more cycles of the same chemotherapy. Radiotherapy was given to the potential areas of soft tissue extensions, 45 to 50 Gy/4.5 to 5 weeks, five weekly fractions. Chemotherapy agent used was 5-fluorouracil [5-FU], 500 mg/day x 5 days, given by intravenous drip infusion and preceded by 20 mg/m[2] calcium leucovorin [LV]. Statistically significant lower local and distal failures were obtained in the combined modality group. Failures were significantly higher in patients with higher performance status, poor pathological differentiation, and in patients where the surgical resection margins were positive. The one year disease free survival [DPS] was significantly higher in group III as compared to groups I and II:. 83%, 50% and 58% respectively. The overall survival [OS] was nearly the same in the three groups of the study without statistically significant differences