Clinical Research of the Preoperative Radiochemotherapy of Mid-low Locally Advanced Rectal Cancer

Objective:To evaluate the efficacy of neoadjuvant radiotherapy alone versus chemoradiotherapy in patients with mid-low locally advanced recal cancer. Methods: Data of 60 patients with advanced (stage T3or T4)rectal cancer,undergone neoadjuvant therapy in our hospital from October 2006 to October 2008 were analyzed. Thirty patients received preoperative radiotherapy (30 Gy,3 Gy per fractions over 2 weeks) alone (Group A),and 30 patients received preoperative radiotherapy concomitant with Xeloda based preperative chemoradiotherpy (Group B). Surgery was done 2～4 weeks after this preoperative treatments. Results: Forty-seven patients underwent operations,including 15 abdominoperineal resections,9 Hartmann's procedures and 23 anterior resections. In pathological findings,tumor and nodal downstaging were observed in 11 patients of Group A (36.7%),and 18 of Group B (60%) (P0.05). The sphincter preservation rate was 30%(6/20) in Group A,and 63%(17/27) in Group B (P0.05). The Resection rates were 66.7% and 90% respectively (P0.05 ),Local recurrence rates were 10% and 3.7% respectively (P0.05 ),The quality of life in Group A after operation were lower than that in Group B (P0.01). Conclusion: Combined preoperative xeloda and radiotherapy for lower rectal cancer is able to significantly improve the operative resection,anal preservation and amendment the quality of life after operation.