Preoperative Neoadjuvant therapy for lower local advanced rectal carcinoma

Objective: Studying the clinical effect of preoperative Neoadjuvant therapy in lower locally advanced rectal carcinoma. Methods 45 patients with lower locally advanced rectal carcinoma were received preoperative Neoadjuvant therapy. Patients received oxaliplatin on day 1, plus leucovorin and 5-Fu (intravenous bolus) from day 1 to day 3, every 3 weeks for total two cycles. Radiotherapy was given with total dose of 45Gy, 5 times per week, 1.8Gy in each fraction. Operation was performed 4 to 6 weeks later after chemoradiotherapy. Results After Preoperative neoadjuvant therapy, Pathological examination showed 53.3 % cases were in TRG3 tumor regression grade and complete pathologic response in 4 patients. Tumor stage decreased in 60.0% (27/45), the average max diameter of tumor decreased 35.8%. Nodal stage decreased in 62.2% (28/45) of patients. 71.1% (32/45) cases received sphincter-preserving surgery and 17.8 % (8/45) cases received abdominoperineal resection. 8.9% (4/45) cases didn' t received operation because of tumor disappear after preoperative neoadjuvant therapy. Conclusion Combined preoperative neoadjuvant therapy with surgery is a better therapy for lower advanced rectal cancer, which can decrease tumor stage, therefore improve respectability and anal sphincter preservation rate.