Outcome of Adjuvant Concurrent Chemo-Radiation in Operated Locally Advanced Rectal Cancer.
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Date
2015-09
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Abstract
Background: Rectal cancer is one of the most common cancers in Kashmir, India. The
clinical course of patients treated with surgery alone has been characterized by a high death
rate and also by the pain and disability associated with pelvic recurrence of the tumor.
Adjuvant radiation combined with chemotherapy has been studied for prevention of such
recurrences. We treat more than 200 rectal cancer patients annually at our center. Most of the
patients registered at our center are those who have been already subjected to surgery at the
peripheral hospitals. We studied role of 5-fluorouracil (5-FU) and calcium leucovorin
concurrently with radiotherapy in Dukes’ stage B2 and C and toxicities thereof in the adjuvant
setting. Objective: To assess the outcome of concurrent chemoradiation in operated locally
advanced treated cancer patients. Materials and Methods: In operated Dukes’ B2 and C
rectal cancer patients, we conducted a prospective non-randomized study comprising of 40
patients between 2012 and 2014. Patients were treated with two hours protracted infusion of
calcium leucovorin 500 mg/m2 on day 1 followed by 5-fluorouracil 500 mg/m2 on days 1 to 5
and repeated four weekly for total of six cycles. Radiotherapy of 45 Gray in 20 fractions was
delivered concurrently with chemotherapy for first two cycles. Results: Combination of
chemotherapy and radiotherapy in a concurrent setting appears to be more efficient in
reducing local recurrence rates and improving survival than either modality alone. Toxicities
with this schedule were mostly gastrointestinal mucositis, but no treatment interruption was
needed. Conclusion: A combination of 5-fluorouracil and radiotherapy can be administered
in operated locally advanced rectal cancer patients.
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Keywords
Rectal cancer, 5-fluorouracil, Adjuvant, External beam radiotherapy
Citation
Mustafa Syed Arshad, Ismail M, Zaffar Saquib, Hassan Ghulam, Qureshi Waseem, Kadri S M. Outcome of Adjuvant Concurrent Chemo-Radiation in Operated Locally Advanced Rectal Cancer. Journal of Enam Medical College. 2015 Sept; 5(3): 139-144.