The Role of Postoperative Pelvic Radiation Therapy in Rectal Cancer / 대한치료방사선과학회지

ABSTRACT

To evaluate the role of postoperative pelvic radiation therapy in rectal cancer, a retrospective analysis was done on 189 patients with modified Astler-Coller stages B2+3, C1, and C2+3 who were treated from February 1979 to June 1986. Forty-seven patients were staged as B2+3, 17 as C1, and 125 as C2+3. As a curative resection, 41 received low anterior resection, 143 received abdomino-perineal resection, and five received pelvic exenteration. The survival and disease-free survival rates of the total patients at five year were 45.3% and 44.1%, respectively. The stage was an important prognostic factor for survival and disease-free survival the survival rates at five year were 55.7% in B2+3, 65.7% in C1, and 36.4% in C2+3, respectively (p<0.01). The liver was the most frequently involved organ of recurrence followed by the lung and the perineum. The patients who received low anterior resection achieved better disease-free survival but were more prone to late radiation bowel morbidities than those who received abdominoperineal resection. Postoperative pelvic radiation therapy proved to be effective in locoregional disease control but did not prevent the appearance of distant metastasis, which was of major concern in advanced stages. Patterns of treatment failure, and factors relating to radiation morbidity are discussed, and therapeutic options for better results are proposed.