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Combined modality preoperative therapy for unresectable rectal cancer
B Percarpio1, J Bitterman, K Sabbath
1Joint Radiation Oncology Program, St. Mary's Hospital.
Connecticut Medicine
|January 1, 1992
Summary
Preoperative combined modality therapy, including pelvic irradiation and infusion chemotherapy, showed promising results for locally advanced rectal cancer. This approach facilitated successful surgical resection and demonstrated encouraging response rates in a small patient cohort.
Area of Science:
- Oncology
- Surgical Oncology
- Radiation Oncology
Background:
- Locally advanced rectal cancer presents surgical challenges due to tumor fixation within the pelvic region.
- Fixation to bony pelvis or soft tissues complicates complete tumor removal.
Purpose of the Study:
- To evaluate the safety and efficacy of preoperative combined modality therapy for locally advanced rectal cancer.
- To assess the feasibility of surgical resection following neoadjuvant treatment.
Main Methods:
- Seven patients with locally advanced rectal cancer received preoperative pelvic irradiation (4500-5040 cGy).
- Concomitant infusion chemotherapy included 5-fluorouracil and mitomycin-C.
- Patients underwent surgical resection of the primary tumor after neoadjuvant treatment.
Main Results:
- The combined modality therapy was reasonably tolerated by all patients.
- All seven patients successfully underwent resection of the primary rectal tumor.
- Two patients achieved a complete response, with no residual cancer detected in surgical specimens.
- Short-term follow-up showed satisfactory healing and no local or distant recurrence.
Conclusions:
- Preoperative combined modality therapy is a viable option for locally advanced rectal cancer.
- This neoadjuvant approach can facilitate surgical resection and improve outcomes.
- Further clinical trials are warranted based on these encouraging preliminary results.