International Journal of Applied Research
Vol. 3, Issue 9, Part D (2017)
A feasibility study of Neoadjuvant chemoradiation in locally advanced carcinoma rectum on tumor down staging and sphincter preservation
Behera Manoj Kumar, Mittal Kailash, Dutta Samrat, Kapoor Rakesh and Gupta Rajesh
To evaluate the rate of sphincter preservation, tumor regression, local control and acute toxicities of Neoadjuvant chemoradiation for locally advanced distal rectal carcinoma.
Method: Patients with clinical T3 / T4 cancer of distal rectum were taken into the study to receive Combined Neoadjuvant chemoradiation followed by surgical resection. All the patients were given inj. Leucovorin (30 mg/m2) and inj. 5-FU (325 mg/m2) D1 concurrently with radiation of 45 Gy/25# @ 1.8 Gy for 5 weeks. Surgery was performed 4-6 weeks after completion of chemoradiation. The primary end points of this study are tumor regression and sphincter preservation and acute normal tissue toxicities were taken into account as secondary point.
Results: A total of 15 patients have been evaluated from July 2007 to July 2008. The study shows overall resectiability rate of 86.6% and a sphincter preservation rate of 53% as 53% of patients underwent Low anterior resection (LAR) and Abdominoperineal resectioin (APR) was done in 33%. Only 13% patients were declared inoperable in whom palliative colostomy were done. Non hematological toxicities (diarrhea of grade III – 20% and skin reaction of grade II- 20%) were main complication observed during neoadjuvant chemoradiation. Grade II hematological toxicity (neutropenia) reported only in one patient. With a median follow up period of 6 months no loco regional failure has been seen. One patient has failed distantly presenting with lung metastasis without any local failure.
Conclusion: Concurrent preoperative chemoradiation for locally advanced carcinoma rectum is associated with improved tumor respectability which results in improved sphincter preservation, local control and is relatively safe, effective and well tolerated.
How to cite this article:
Behera Manoj Kumar, Mittal Kailash, Dutta Samrat, Kapoor Rakesh and Gupta Rajesh. A feasibility study of Neoadjuvant chemoradiation in locally advanced carcinoma rectum on tumor down staging and sphincter preservation. International Journal of Applied Research. 2017; 3(9): 236-244.