[Multimodality therapy in progressive rectal carcinoma]

Rectal carcinoma cannot be controlled only by surgical technique despite radical resection (TME, systematic lymphadenectomy). Therefore, progressive rectal carcinoma of stage 2 + 3 that are detectable pre-operatively by CT and 3-D endosonography, should be treated by a multimodal concept. Based on recent Scandinavian and Dutch studies, we introduced a modified post-operative short-term radiation in which the acute toxicity on tumor tissue corresponds to that of the Swedish and Dutch studies (5 x 5 Gy), its late toxicity, however, is reduced by 20%. Thus, we expect to reduce long-term damages to the pelvic organs, i.e. incontinence. A phase 2 study revealed good therapeutic management due to interdisciplinary tumor conference and a high acceptance by patients. The post-operative rate of wound healing is a bit higher, but does not influence the time of hospitalization.