Efficacy of preoperative concurrent chemoradiotherapy in treatment of locally advanced rectal cancer

Objective: To evaluate the safety and efficacy of preoperative concurrent chemoradiotherapy in locally advanced low rectal cancer. Methods: 30 patients with newly diagnosed locally advanced low rectal cancer were finally included in this study. Total mesorectal excision(TME),Abdominoperineal resection(Miles),low anterior resection(Dixon)and Anal-abdominal resection anastomosis(Parks) were chosen appropriately according to patients’ situation. The irradiation regimen was: 6MV X-ray,SAD=100 cm, total dose 46 Gy and 200 cGy/f,5 f/w. The concurrent chemotherapy regimen was 5-Fu plus CF for 2 courses. Surgery was performed on 4～6 weeks after chemoradiation. Results: All the patients completed the planned treatment. The rate of Grade 1,2 acute toxicity was 66.7% and Grade 3,4 was 20%. 60% patients had a T downstaging and 40% patients had a N dowstaging. A complete pathological remission was observed in 4 cases (13.3%) and the sphincter preservation rate was 46.7%. Complications after operation was 33.3%. Conclusion: Preoperative concurrent chemoradiotherapy is feasible and effective. It improves clinical stage, sphincter preservation and the quality of life in patients with locally advanced low rectal cancer.