Effect of neoadjuvant therapy in treatment for advanced lower rectal cancer

Background and purpose:It is difficult to improve the curative resection rate and anal preservation rate of advanced lower rectal cancer,so we investigated the effect of preoperative chemoradiotherapy (neoadjuvant therapy) in treatment for advanced lower rectal cancer. Methods:A total of 23 advanced lower rectal cancer patients who had indications for abdominal-per rection(APR) according to preoperative evaluation were first treated with preoperative chemoradiotherapy.Patients received radiotherapy five times a week at a dose 200 cGy daily up to 4 000 cGy in 4 weeks.Concomitantly patients received continuous venous chemotherapy of OXA 130 mg/(m 2 .d_ 1 ), 5-Fu (500 mg/ m 2 . D_ 1-5 ), and CF (300 mg/m 2 . d_ 1-5 ). Surgical operations were performed 4-6 weeks after neoadjuvant therapy.Results:Tumor stages were down-staged and curative resection with sphincter saving operation were carried out in 15 of 23 patients. The rate of sphincter preservation was 65%(15/23), in which,82% patients showed good function of sphincter.Conclusions:Neoadjuvant therapy in advanced lower rectal cancer patients has shown its efficacy in down-staging, increase of resectability and sphincter preservation. The side effects were mild and well tolerated.