Advanced SearchSearch Tips
Long Term Outcomes of Preoperative versus Postoperative Concurrent Chemoradiation for Locally Advanced Rectal Cancer: Experience from Ramathibodi Medical School in Thailand
facebook(new window)  Pirnt(new window) E-mail(new window) Excel Download
 Title & Authors
Long Term Outcomes of Preoperative versus Postoperative Concurrent Chemoradiation for Locally Advanced Rectal Cancer: Experience from Ramathibodi Medical School in Thailand
Darunikorn, Pichayada; Puataweepong, Putipun; Dhanachai, Mantana; Dangprasert, Somjai; Swangsilpa, Thiti; Sitathanee, Chomporn; Jiarpinitnun, Chuleeporn; Pattaranutaporn, Poompis; Boonyawan, Keeratikan; Chansriwong, Pichai;
  PDF(new window)
Objectives: The study analyzed and compared the long term outcome in locally advanced rectal cancer treated with preoperative and postoperative concurrent chemoradiation (CCRT). Materials and Methods: A retrospective review of 105 patients with stage T3-T4 or regional lymph node positive adenocarcinoma of rectum treated with preoperative or postoperative CCRT at Ramathibodi Hospital during 2005 to 2010 was performed. The results of treatment were reported with 5-year overall survival (OS), 5-year locoregional recurrence free survival (LRFS), and toxicity according to preoperative versus postoperative concurrent chemoradiation (CCRT) groups. Results: Among 105 patients, 34 (32%) were treated with preoperative CCRT and 71 (68%) with postoperative CCRT. At the median follow-up time of 50.5 months (range 2-114 months), five-year OS and LRFS of all patients were 87% and 91.6%, respectively. The study found no difference in 5-year OS (81.7% vs 89.2 %) or LRFS (83.4% vs 95.1%) between preoperative versus postoperative CCRT. Seven cases of loco-regional recurrence were diagnosed, 4 (11.8%) after preoperative CCRT and 3 (4.2%) after postoperative CCRT. The recurrent sites were anastomosis in all patients. There was no significant factor associated with outcome after univariate and multivariate testing. Grade 3 or 4 acute and late complications were low in both preoperative and postoperative CCRT groups. Conclusions: Locally advanced rectum cancer patients experience good results with surgery and adjuvant concurrent chemoradiation.
Rectal cancer;chemoradiation;locally advanced;outcome;
 Cited by
Outcomes of Preoperative Chemoradiotherapy and Combined Chemotherapy with Radiotherapy Without Surgery for Locally Advanced Rectal Cancer,;;;;;;

Asian Pacific Journal of Cancer Prevention, 2016. vol.17. 7, pp.3511-3514 crossref(new window)
Akhavan A, Binesh F, Soltani A (2014). Survival of rectal cancer in Yazd, Iran. Asian Pac J Cancer Prev, 15, 4857-60. crossref(new window)

Arnaud JP, Nordlinger B, Bosset JF, et al (1997). Radical surgery and postoperative radiotherapy as combined treatment in rectal cancer. Final results of a phase III study of the European Organization for Research and Treatment of Cancer. Br J Surg, 84, 352-7. crossref(new window)

Kacar S, Varilsuha C, Gurkan A, et al (2009). Pre-operative radiochemotherapy for rectal cancer. A prospective randomized trial comparing pre-operative vs postoperative radiochemotherapy in rectal cancer patients. Acta Chir Belg, 109, 701-7.

Krook J E, Moertel CG, Gunderson LL, et al (1991). Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med, 324, 709-15. crossref(new window)

Lee JH, Kim SH, Jang HS, et al (2013). Preoperative elevation of carcinoembryonic antigen predicts poor tumor response and frequent distant recurrence for patients with rectal cancer who receive preoperative chemoradiotherapy and total mesorectal excision: a multi-institutional analysis in an Asian population. Int J Colorectal Dis, 28, 511-517. crossref(new window)

Miller RC, Sargent DJ, Martenson JA, et al (2002). Acute diarrhea during adjuvant therapy for rectal cancer: a detailed analysis from a randomized intergroup trial. Int J Radiat Oncol Biol Phys, 54, 409-13. crossref(new window)

Moore MA, Attasara P, Khuhaprema T, et al (2010). Cancer epidemiology in mainland South-East Asia - past, present and future. Asian Pac J Cancer Prev, 11, 67-80.

Park JH, Yoon SM, Yu CS, et al (2011). Randomized phase 3 trial comparing preoperative and postoperative chemoradiotherapy with capecitabine for locally advanced rectal cancer. Cancer, 117, 3703-12. crossref(new window)

Park P (2014). Comparative survival effectiveness between pre-operative and postoperative chemoradiotherapy for locally advanced rectal cancer: a retrospective study in Phramongkutklao Hospital. J Med Assoc Thai, 97, 1-8.

Rodel C, Liersch T, Becker H, et al (2012). Preoperative chemoradiotherapy and postoperative chemotherapy with fluorouracil and oxaliplatin versus fluorouracil alone in locally advanced rectal cancer: initial results of the German CAO/ARO/AIO-04 randomised phase 3 trial. Lancet Oncol, 13, 679-87. crossref(new window)

Roh MS, Colangelo LH, O’Connell MJ, et al (2009). Preoperative multimodality therapy improves disease-free survival in patients with carcinoma of the rectum: NSABP R-03. J Clin Oncol, 27, 5124-30. crossref(new window)

Sauer R, Becker H, Hohenberger W, et al (2004). Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med, 351, 1731-40. crossref(new window)

Sauer R, Liersch T, Merkel S, et al (2012). Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years. J Clin Oncol, 30, 1926-33. crossref(new window)

Thomas PR, Lindblad AS (1988). Adjuvant postoperative radiotherapy and chemotherapy in rectal carcinoma: a review of the Gastrointestinal Tumor Study Group experience. Radiother Oncol, 13, 245-252. crossref(new window)

Wolmark N, Wieand HS, Hyams DM, et al (2000). Randomized trial of postoperative adjuvant chemotherapy with or without radiotherapy for carcinoma of the rectum: National surgical adjuvant breast and bowel project protocol R-02. J Natl Cancer Inst, 92, 388-96. crossref(new window)

Yeh CH, Chen MF, Lai CH, et al (2012). Comparison of treatment results between surgery alone, preoperative short-course radiotherapy, or long-course concurrent chemoradiotherapy in locally advanced rectal cancer. Int J Clin Oncol, 17, 482-490. crossref(new window)