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Clinical Trial
. 2009 Dec 21:4:67.
doi: 10.1186/1748-717X-4-67.

Prospective phase II study of preoperative short-course radiotherapy for rectal cancer with twice daily fractions of 2.9 Gy to a total dose of 29 Gy--long-term results

Matthias Guckenberger  1 , Joern Wulf, Andreas Thalheimer, Daniel Wehner, Arnulf Thiede, Gottfried Müller, Marco Sailer, Michael Flentje
Affiliations
Clinical Trial

Prospective phase II study of preoperative short-course radiotherapy for rectal cancer with twice daily fractions of 2.9 Gy to a total dose of 29 Gy--long-term results

Matthias Guckenberger et al. Radiat Oncol. .

Abstract

Background: To evaluate clinical outcome after preoperative short-course radiotherapy for rectal cancer with twice daily fractions of 2.9 Gy to a total dose of 29 Gy and adjuvant chemotherapy for pathological stage UICC >or= II.

Methods: 118 patients (median age 64 years; male : female ratio 2.5 : 1) with pathological proven rectal cancer (clinical stage II 50%, III 41.5%, IV 8.5%) were treated preoperatively with twice daily radiotherapy of 2.9 Gy single fraction dose to a total dose of 29 Gy; surgery was performed immediately in the following week with total mesorectal excision (TME). Adjuvant 5-FU based chemotherapy was planned for pathological stage UICC >or= II.

Results: After low anterior resection (70%) and abdominoperineal resection (30%), pathology showed stage UICC I (27.1%), II (25.4%), III (37.3%) and IV (9.3%). Perioperative mortality was 3.4% and perioperative complications were observed in 22.8% of the patients. Adjuvant chemotherapy was given in 75.3% of patients with pathological stage UICC >or= II. After median follow-up of 46 months, five-year overall survival was 67%, cancer-specific survival 76%, local control 92% and freedom from systemic progression 75%. Late toxicity > grade II was observed in 11% of the patients.

Conclusions: Preoperative short-course radiotherapy, total mesorectal excision and adjuvant chemotherapy for pathological stage UICC >or= II achieved excellent local control and favorable survival.

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Figures

Figure 1
Figure 1
Overall survival (OS), cancer specific survival (CSS) and disease free survival (DFS).
Figure 2
Figure 2
Local control (LC) and freedom from systemic progression (FSP).
See this image and copyright information in PMC

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