Premium
Preoperative short‐term radiotherapy in rectal carcinoma. A preliminary report of a prospective randomized study
Author(s) -
Cedermark Björn,
Theve Nils Olof,
Rieger Ake,
Wahren Britta,
Glas Jan Erik,
Rubio Carlos,
Öst Ake,
Broström Lennart,
Ekelund GÖRan,
Forsgren Lennart,
Friberg Sten,
Glas Ulla,
Jäderholm Bengt,
Landberg Torsten,
Ljungdahl Ingolf,
Molin Kerstin,
Poppen Bertil,
Rietz KarlAxel,
Räf Lars,
Schager Nils,
Öhman Ulf
Publication year - 1985
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19850315)55:6<1182::aid-cncr2820550607>3.0.co;2-7
Subject(s) - medicine , surgery , radiation therapy , randomized controlled trial , abdominoperineal resection , regimen , laparotomy , stage (stratigraphy) , colorectal cancer , prospective cohort study , sepsis , pelvic exenteration , carcinoma , cancer , paleontology , biology
Between 1980 and 1983, 373 patients with clinically resectable rectal adenocarcinoma entered a prospective randomized study aimed to evaluate the effect of short‐term preoperative radiotherapy. Protocol violations were identified in 21 instances. Of the remaining 352 patients, 182 were randomized to surgical treatment only (S‐group). Immediately, before surgery, 170 patients were irradiated to the pelvic region with 25 Gy (2500 rad) during a 5‐day period (RT‐group). Of these patients, 59% underwent abdominoperineal excision, 38% anterior resection, and 3% laparotomy only. At surgery distant metastases were discovered in 32 patients (9%). There were no significant differences between the groups in the distribution of age, sex, operative methods, and tumor stage according to the original Dukes' classification. During the follow‐up time, ranging between 6 months and 3 years, tumor recurrence occurred in 35 patients, 19 in the S‐group and 16 in the RT‐group. Fifteen patients in the S‐group had pelvic recurrence compared to 10 patients in the RT‐group. Distant metastases occurred in six and eight patients, respectively. Two patients in each group had both pelvic and distant recurrence. There was no correlation between tumor recurrence and type of operation. Median time interval from diagnosis to pelvic recurrence was 10 months in the S‐group and 16 months in the RT‐group. Postoperative complications in the form of wound sepsis were slightly more common in the RT‐group. In summary, the applied treatment regimen, is well‐tolerated and apparently does not affect the Dukes' stage of the tumor. Although there is no statistically significant difference, there is a trend of less pelvic recurrence in patients receiving preoperative radiotherapy. Cancer 55:1182‐1185, 1985.