INTEREST OF RADIOCHEMOTHERAPY IN THE RECTAL CANCER


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Messaoud Ayad1,Naima Haoui2
1EHS Centre anti cancer,2Centre anti cancer

Abstract

Background

We propose the study of treating patients with locally advanced rectal cancer by radiochemotherapy followed by surgery with TME. The objective is to make inoperable patients, operable after the radio chemotherapy and get a pathologic complete response at the maximum of the patients and decrease the rate of local recurrence and distant. 

Method

During 2008-2011, we have recruited 80 patients in our radiotherapy oncology department of Blida, age is between 18 and 70 years. Radiotherapy (RT) is made at a dose of 45Gy in the pelvis, the patient received three courses of CT (FOLFOX) for all the radiation therapy. All patients were assigned to surgeons for surgery (TME). 

Results

Rectal bleeding was found in 89% of patients. 70% of our patients had a low rectal cancer 98% of our patients are classes T3, T4. 78 % N +, and only 21% N- . The RTCT was well tolerated by patients, no side effects Grade 4. 77 had surgery 55 % of our patients had a conservative surgery. 41 % had an abdomino perineal resection. The downstaging affects more 45% of tumors after the RTCT. And we have 12% complete pathological response. 61 % of objective response. The local recurrence rate is (4%). relapse distance is 22.9%. The average time of relapse was 14 months away. The survival rate at 5 years was 64%.  Relapse distance during follow- up of patients operated is 22.9%. 

Conclusion

Our result of 12 % complete response is less than the results of others studies (16 % to 21 %). Our result of local relapse is similar to international studies.Every patient should have a personalized treatment for all steps (radiochemotherapy, surgery, adjuvant chemotherapy).