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Title: Chemoradiotherapy for Rectal Cancer Halts Recurrences in 5-Year Study: Presented at SSO

"Chemoradiotherapy for Rectal Cancer Halts Recurrences in 5-Year Study: Presented at SSO"

By Carole Bullock CHICAGO -- March 19, 2008 -- About three quarters of patients treated with preoperative chemoradiotherapy (pCRT) for mid-low rectal cancer were alive at 5 years in a prospective study presented here at the Society of Surgical Oncology (SOS) 61st Annual Cancer Symposium. At a median follow-up of 86 months (range 54-160 months), overall survival at 5 and 10 years was 75% and 66%, respectively, while disease-free survival was 82% and 80%, respectively. Salvatore Pucciarelli, MD, Professor of Clinical and Experimental Surgery, Department of Oncological and Surgical Sciences, University of Padua, Padua, Italy, reported the findings in a poster session on March 14. Researchers determined survival and late complications after pCRT among 126 consecutive patients aged 18 to 80 years who were undergoing surgery for rectal cancer from January 1994 to October 2002 and were followed for a minimum of 5 years. Survival was calculated using the Kaplan-Meier method and late complications were defined as occurring 6 months after surgery. All patients had primary rectal adenocarcinoma located up to 11 cm from the anal verge and received pretreatment radiotherapy administered with conventional fractionation and concomitant 5-fluorouracil (5-FU)-based chemotherapy. Treatment included a radiation dose of at least 40 Gy. Chemotherapy was administered by bolus (350 mg/m[²/day) or by continuous venous infusion (225-300 mg/m²/day).

Patients were evaluated every 4 months for the first 2 years, every 6 months during year 3, and yearly thereafter.

Although a sphincter-saving procedure was performed in 111 (88%) patients, at
the last follow-up, only 79% of these were stoma free.

The rate of complete pathological response was 16%, according to Dr. Pucciarelli.

Complications occurred in 33% of patients and most were radiation related. There were 4 ureteric strictures, 2 pelvic fractures, and 2 rectovaginal fistulas associated with higher radiation dose (P < .01), the investigators noted.

Other frequent complications included incisonal/parastomal hernia (n = 27) and anastomotic stricture (n = 6); 21 patients required surgical intervention.

The researchers noted that the late incidence of morbidity was "relevant." Late complications occurred in 33% of patients, late reintervention was required in 17%, and 11% of patients had sphincter-sparing surgery requiring stoma.

[Presentation title: Satisfactory Long-Term Oncological Results But Relevant Morbidity After Preoperative Chemoradiotherapy for Mid-Low Rectal Cancer: A Single Institution Experience With a Median Follow-Up of 7 Years. Abstract P61]

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