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The effect of postoperative pelvic irradiation after complete resection of metastatic rectal cancer
Author(s) -
Chang Chul Young,
Kim Hee Cheol,
Park Young Suk,
Park Joon Oh,
Choi Doo Ho,
Park Hee Chul,
Cho Yong Beom,
Yun Seong Hyeon,
Lee Woo Yong,
Chun HoKyung
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.22109
Subject(s) - medicine , colorectal cancer , rectum , stage (stratigraphy) , radiation therapy , chemotherapy , surgery , primary tumor , cancer , metastasis , paleontology , biology
Abstract Background and Objectives The 2010 NCCN clinical practice guidelines recommend radiation as a part of the standard adjuvant or neoadjuvant treatment for stage IV rectal cancer patients. This study evaluated the oncologic efficacy of postoperative radiotherapy (RTx) in loco‐regional control after complete removal of primary and metastatic lesions in stage IV rectal cancer. Methods Sixty‐eight patients with metastatic rectal cancer were enrolled and analyzed. Twenty‐eight of the enrolled patients received concurrent postoperative RTx with chemotherapy (RTx group) and the remaining 40 received only postoperative systemic chemotherapy (CTx) without RTx (non‐RTx group). The eligibility criteria were as follows: a primary rectal tumor located in the low or mid‐rectum, no postoperative macroscopic and microscopic evidence of residual tumor in primary and metastatic sites, and no history of prior CTx or pelvic RTx. Results The recurrence rates were 75.0% in the RTx group and 72.5% in the non‐RTx group. Local recurrence rates were 7.1% (RTx group) and 22.5% (non‐RTx group) ( P = 0.108). There were no differences in overall survival (OS), local recurrence‐free survival, and disease‐free survival between the two groups. The 2‐year OS rates were 78.9% (RTx group) and 74.1% (non‐RTx group) ( P = 0.395). Conclusions Survival benefit of postoperative RTx in stage IV rectal cancer after complete removal of tumors was not apparent. RTx could be recommended for selected patients at high risk of local recurrence or for palliation of symptoms. J. Surg. Oncol. 2012; 105:244–248. © 2011 Wiley Periodicals, Inc.