The clinical efficacy of neoadjuvant chemoradiotherapy combined with radical resection for advanced rectal cancer

Objective To evaluate the clinical efficacy of neoadjuvant chemo radiotherapy combined with surgical treatment for advanced rectal cancer.Methods Fifty-one patients with advanced rectal cancer were randomly divided into treatment group and control group by random number table.In treatment group,26 cases received three-dimensional conformal radiotherapy synchronization XELOX chemotherapy for 2 cycles,then they received radical resection after 4-6 weeks.Twenty-five cases in control group received neoadjuvant chemotherapy with XELOX for 2 cycles,then received radical resection.Results The objective response rate in treatment group was 84.6％ (22/26),and in control group was 60.0％(15/25),there was significant difference between two groups (P =0.049).Radical resection in treatment group was 96.2％ (25/26),significantly higher than that in control group 76.0％ (19/25)(P =0.037).The sphincter preservation rate in treatment group was 61.5％ (16/26),and in control group was 20.0％ (5/25),there was significant difference between two groups (P =0.003).The pathologic complete response rate in treatment group was 26.9％ (7/26),significantly higher than that in control group 4.0％ (1/25)(P =0.024).The 1,2 and 3 year survival rate in treatment group were 88.0％(22/25),60.0％(15/25),32.0％(8/25),which were significantly higher than those in control group 62.5％ (15/24),29.2％ (7/24),8.3％ (2/24) (P =0.038,0.030,0.040).The 1,2,and 3 year recurrence rate in treatment group were 8.0％(2/25),20.0％(5/25),36.0％ (9/25),which were significantly lower than those in control group 33.3％ (8/24),44.8％(12/24),66.7％ (16/24) (P=0.028,0.027,0.032).Conclusion Neoadjuvant chemoradiotherapy can improve the rate of surgical resection,sphincter preservation and prolong survival of rectal cancer,it can be used as a kind of effective treatment for rectal cancer. Key words: Rectal neoplasms;  Radiotherapy;  Neoadjuvant chemotherapy