[The chemoradiotherapy of advanced colorectal carcinoma--the results and toxicity in a pilot study with 44 patients]

Forty-four evaluable patients with advanced colorectal cancer were treated with simultaneous chemoradiotherapy to the small pelvis. In 34 patients locally recurrent disease and in ten patients primary tumors had been resected. 34 patients had gross and ten patients had microscopic residual tumor after surgical resection, seven of the latter with distant metastases. Radiotherapy was given to a dose of 50 Gy in five weeks. During the first two weeks of treatment simultaneous chemotherapy was applied, using continuous 24 hour intravenous infusion of 5-fluorouracil at 500 mg/m2 on days 1 to 5 and 8 to 12 and bolus injection of mitomycin C at 5 mg/m2 on days 5 and 12. Two-year local control rates in patients with microscopic residual were 76% compared to 36% in patients with gross residual disease. Two-year survival rates were 5/7 patients for microscopical residual tumor and 13/30 patients (44%) with gross residual tumor. Considerable rates of acute and late toxicity were observed, however, these rates were not higher than results reported by others. In view of the increasing interest in chemoradiotherapy for residual and recurrent colorectal cancers, a randomized multicenter study has been opened (ARO I/91). Aim of this clinical trial is to find out, whether patients with advanced colorectal cancer benefit from simultaneous chemoradiotherapy.