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Title   국소진행된 직장암에서 수술 전 동시화학요법과 방사선 치료 성적 ( The Treatment Results of Preoperative Concurrent Chemoradiation in Locally Advanced Rectal Cancer )
Publicationinfo   2000 Jan; 032(05): 933-943.
Key_word   Rectal neoplasm, Preoperative chemoradiation, Sphincter Preservation
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Abstract   Purpose: To assess the tumor response, sphincter preservation, acute toxicity and survival with preoperative concurrent chemoradiation in locally advanced rectal cancer. Materials and Methods: Fifty-four patients were treated with preoperative chemoradiaton for tumor downstaging and sphincter preservation. Radiation was delivered to whole pelvis to 45 Gy followed by a boost 5.4 Gy to primary tumor site. Chemotherapy consists of concurrent 2 cycles of 5-fluorouracil (500 mg/m /day) and leucovorin (20 mg/m/day). Surgery was performed approximately 6 weeks after treatment. Results: Median follow-up period and rate were 48 months and 98%, respectively. The downstaging including primary tumor and lymph node occurred in 64%. Three of 53 patients (6%) had pathologic complete response. The resectability of tumor was 98%. A sphincter preservation was possible in 61%. Three patients developed grade 4 hematologic toxicity. Grade 3 skin erythema and diarrhea were 24% and 18%, respectively. The 5-year survival and local disease-free survival were 62% and 89%, respectively. Local failure and distant metastasis rate were 9% and 35%, respectively. Conclusion: Preoperative chemoradiation affords considerable downstaging with acceptable acute toxicity and postoperative morbidity. Also sphincter preservation is feasible by improved downstaging of tumor. This treatment could be improved local control of tumor, and may have a potential for long-term survival.
저 자   김준상(Jun Sang Kim),김재성(Jae Sung Kim),장지영(Ji Young Jang),윤완희(Wan Hee Yoon),송규상(Kyu Sang Song),인혜경(Hae Kyeung In),조문준(Moon June Cho)