multimodal treatment of rectal cancer – eValuation of preoperatiVe radiotherapy

Colorectal cancer constitutes 10% of all malignant neoplasms and is the fourth most common cancer in men and the third most common cancer in women, worldwide (second most common in Poland). Unfortunately, despite large scale screening programs, changes in diet and lifestyle, colorectal cancer incidence rates for both male and female patients has increased. the aim of the study was to analyze the influence of preoperative radiotherapy (RTH) on the survival and local recurrence rate of patients with rectal cancer, subject to surgical treatment with postoperative (adjuvant) chemotherapy (CTH). material and methods. The study group comprised 132 patients, including 53 females and 79 males. Patients were divided into the following groups: I – 70 patients treated by means of preoperative radiotherapy, II – 62 patients treated by means of surgery alone. Patients qualified to radiotherapy were diagnosed with stage B (39 patients) and stage C (31 patients) cancer, according to Duke’s classification (CT). The patients received 5 Gy each day for a period of 5 days (25 Gy altogether), and underwent surgery. Postoperative pathomorphology demonstrated the following: group I comprised 39 patients with stage B and 31 patients with stage C cancer, whereas group II comprised 34 and 28 patients, respectively. Patients with stage B and C (both groups) received postoperative chemotheraphy – six courses of 5-FU 435 mg/kg/d with leucovorin 20 mg/m2. results. Kaplan-Meier’s survival analysis was applied in each group, according to the following: grade of tumor (pT), lymph node involvement (pN, pN „+”,pN „-”), type of surgical resection, stage of cancer, administration of radiotherapy, and presence of local recurrence. Result analysis point to the existing correlation between radiotherapy and the five-year survival rate (p=0.031), and local recurrence (stage B: p=0.1; stage C: p=0.049). conclusions. Preoperative radiotherapy, considering prospective studies and our own study render hope for better prospects of treating rectal carcinoma in the future, and better 5-year survival rates. Analysis of the five-year survival rates, local recurrences, and distant complications confirmed the effectiveness and safety of preoperative radiotherapy in the treatment of rectal cancer, considering B and C patients. key words: rectal cancer, preoperative radiotherapy, multimodal treatment of rectal cancer