Adjuvant preoperative radiotherapy for locally advanced rectal carcinoma

• DOI: 10.1007/bf02257783
• Publication Date: 2005-11-22T17:56:11Z
• Authors: P. J. Marsh; R. D. James; P. F. Schofield
• Keywords: Surgical oncology; Distant metastasis; Colorectal Surgery

PURPOSE: A prospective, randomized clinical trial was conducted by the Northwest Rectal Cancer Group to study effects of preoperative radiotherapy given one week before surgery in locally advanced (tethered or fixed) rectal carcinoma. METHODS: total 284 patients were entered into between 1982 and 1986; 141 allocated receive surgical treatment alone, 143 radiotherapy. 10 × cm volume posterior pelvis, centered on tumor, irradiated at a dose 20 Gy, divided four daily fractions 5 Gy each. RESULTS: No differences observed any clinicopathologic variables two arms trial; there no striking down-staging tumors. After minimum follow-up period 96 months, overall cancer-related mortality rates similar both (P =0.21 P =0.09, respectively). There highly significant reduction local recurrences group (12.8 percent x-ray therapy vs. 36.5 surgery;P =0.0001). The majority after occurred inside field (10 cases; 7 percent), with only six cases (5 percent) outside field. difference distant metastasis groups =0.73). CONCLUSIONS: Although is statistically survival benefit whole series, for subset considered surgeon have undergone curative operation. We recommend that this form adjuvant should be offered all cancer who are undergo radical surgery.