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Asian Pac J Cancer Prev ; 16(16): 7315-9, 2015.
Article in English | MEDLINE | ID: mdl-26514530

ABSTRACT

OBJECTIVES: The study analyzed and compared the long term outcome in locally advanced rectal cancer treated with preoperative and postoperative concurrent chemoradiation (CCRT). MATERIALS AND METHODS: A retrospective review of 105 patients with stage T3-T4 or regional lymph node positive adenocarcinoma of rectum treated with preoperative or postoperative CCRT at Ramathibodi Hospital during 2005 to 2010 was performed. The results of treatment were reported with 5-year overall survival (OS), 5- year locoregional recurrence free survival (LRFS), and toxicity according to preoperative versus postoperative concurrent chemoradiation (CCRT) groups. RESULTS: Among 105 patients, 34 (32%) were treated with preoperative CCRT and 71 (68%) with postoperative CCRT. At the median follow-up time of 50.5 months (range 2-114 months), five-year OS and LRFS of all patients were 87% and 91.6%, respectively. The study found no difference in 5-year OS (81.7% vs 89.2 %) or LRFS (83.4% vs 95.1%) between preoperative versus postoperative CCRT. Seven cases of loco-regional recurrence were diagnosed, 4 (11.8%) after preoperative CCRT and 3 (4.2%) after postoperative CCRT. The recurrent sites were anastomosis in all patients. There was no significant factor associated with outcome after univariate and multivariate testing. Grade 3 or 4 acute and late complications were low in both preoperative and postoperative CCRT groups. CONCLUSIONS: Locally advanced rectum cancer patients experience good results with surgery and adjuvant concurrent chemoradiation.


Subject(s)
Adenocarcinoma/therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chemoradiotherapy/mortality , Rectal Neoplasms/therapy , Adenocarcinoma/mortality , Adenocarcinoma/pathology , Capecitabine/administration & dosage , Female , Fluorouracil/administration & dosage , Follow-Up Studies , Humans , Leucovorin/administration & dosage , Male , Middle Aged , Neoplasm Staging , Postoperative Period , Preoperative Period , Prognosis , Rectal Neoplasms/mortality , Rectal Neoplasms/pathology , Retrospective Studies , Schools, Medical , Survival Rate , Thailand , Time Factors
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