Preoperative chemo-radiotherapy in the initially unresectable rectal cancer

ABSTRACT

Seventeen patients with initially unresectable adenocarcinoma of the rectum were treated by preoperative chemo-radiotherapy. Radiation treatment was given for 4000 cGy at 200 cGy per day, 5 days a week to the primary tumor and pelvic lymph nodes. Concomitantly chemotherapy in the form of 5-fluorouracil, 1000 mg/m 2 bolus injection, was given on days 1-4 of radiotherapy. The same chemotherapy dose was repeated on days 29-32 of treatment. Surgical exploration was performed 4-6 weeks after irradiation. Lower abdominal resection with colo-anal anastomosis was done in eight cases and abdomino-perineal resection in six cases. Twelve cases were found to have mobile tumors and two patients found to have tethered lesions. Carcino-embryonic antigen [CEA] as a tumor marker returned back to normal levels in 11 out of 12 cases one month after surgery. Treatment was tolerable in all cases. Eight patients had sphincter preservation by this combined modality of treatment