1. Rectal carcinoma: long-term experience with moderately high-dose preoperative radiation and low anterior resection
- Author
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Kerman, Herbert D., Roberson, Shed H., Bloom, Terry S., Heron, Howard C., Yaeger, Theodore E., Meese, David L., Ritter, Andrew H., Tolland, J. Timothy, and Spangler, Ann E.
- Subjects
Colorectal cancer -- Radiotherapy ,Rectum ,Cancer -- Adjuvant treatment ,Health - Abstract
This report updated an analysis of a 14-year experience of moderately high-dose (45000 to 5000 cGy) preoperative radiation as an adjuvant to low anterior resection of 95 cases of adenocarcinoma of the rectum. The treatment was well tolerated without treatment-related mortality and with a low incidence (5.2%) of severe complications. The local recurrence rate was 4.2%, and distant failure rate was 10.5%. At 5 years, the actuarial survival rate was 66% and the disease-free survival rate was 64%. At 10 years, the actuarial survival rate and disease-free survival rate 52%. The authors concluded that moderately high-dose (4500 to 5000 cGy) neoadjuvant radiation in clinically resectable adenocarcinoma of the rectum in which one segment of the anastomosis was in the preoperative radiation field is a safe, effective adjuvant to low anterior resection and that it offered patients excellent local control, long-term survival and sphincter preservation. Results could be enhanced by chemotherapy, and the authors urged well-designed prospective randomized multicenter trials to determine the most appropriate drugs, dosage, and sequencing of co-adjuvant preoperative radiation therapy and chemotherapy with surgery. Cancer 1992:69:2813-2819.
- Published
- 1992