Preoperative chemo-radiotherapy in rectal cancer effect on down staging and possibility of sphincter sparing surgery

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