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Radiation therapy for unresectable rectal cancer
B D Minsky1, A M Cohen, W E Enker
1Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
International Journal of Radiation Oncology, Biology, Physics
|October 1, 1991
Summary
Pre-operative radiation therapy (RT) for unresectable rectal cancer impacts survival. Achieving negative margins after RT and surgery is crucial for preventing local failure and improving outcomes.
Area of Science:
- Oncology
- Radiation Oncology
- Surgical Oncology
Background:
- Standard treatment for unresectable rectal cancer involves pre-operative radiation therapy (RT) followed by surgery.
- Assessing the impact of RT on local failure and survival is critical for treatment optimization.
Purpose of the Study:
- To evaluate the preliminary results of pre-operative RT and surgery for unresectable rectal cancer.
- To determine the influence of RT on local failure rates and patient survival.
Main Methods:
- Analysis of 22 patients with unresectable rectal cancer (9 primary, 13 recurrent).
- Patients divided into two groups: Group 1 (surgery planned post-RT), Group 2 (no surgery due to extensive pelvic bone destruction).
- Radiation doses administered: 4680 cGy to the whole pelvis with a boost of 360-1440 cGy; some patients received brachytherapy.
Main Results:
- 3-year actuarial survival was 52% (Group 1: 91% vs Group 2: 30%).
- Local failure occurred in 50% of patients; abdominal failure in 23%; distant failure in 9%.
- Negative margins correlated with no local failure, while positive margins had a 73% local failure rate. Complete resection in Group 1 was 58% with no local failure.
Conclusions:
- Pre-operative RT followed by surgery shows promising survival rates in selected rectal cancer patients.
- Achieving complete resection with negative margins is strongly associated with the absence of local failure.
- Further follow-up is necessary to ascertain long-term local failure and survival outcomes.