Results of preoperative radiation therapy in combination with adjuvant chemotherapy for local recurrence of the rectal cancer.

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Fourteen re-operation cases of local recurrence of the rectal cancer were studied clinicopathologically. Seven of 14 cases were treated by preoperative radiation with adjuvant chemotherapy (radiation group), and the remaining cases were treated by surgery alone (non-radiation group). After re-operation, radiation group demonstrated several complications such as peritonitis or bowel obstruction, however, no operative death was observed. Pathological examination on surgical specimens removed by re-operations revealed characteristic features as follows ; 1) In the radiation group, recurrent tumors showed a marked reduction of invasive cancer nests and tendency of localization, and degeneration, necrosis or destruction of cancer cells was prominent in the most deeply invaded area. 2) Various degrees of degeneration can be seen in the cancer nests of perineural invasion often noted in around the prostate and the seminal vesicle, or in lymphatic vessels. After re-operation, 3 cases of the non-radiation group had pelvic recurrence although no recurrence was experienced in the radiation group. The 3 year survival rate of radiation and non-radiation group was 68.6 % and 42.9 %, respectively. It was suggested that the combination therapy of preoperative radiation and adjuvant chemotherapy had significant effects on decrease of local recurrence after re-operation as well as prognostic improvement of pelvic recurrence of the rectal cancer, however, there would be much to be discussed concerning the method and the total dose of radiation in order to reduce complications.
日本大腸肛門病学会の論文

Results of preoperative radiation therapy in combination with adjuvant chemotherapy for local recurrence of the rectal cancer.

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