Preoperative Irradiation of Primarily Non-Resectable Adenocarcinoma of the Rectum and Rectosigmoid

Abstract

In a series of 328 patients with adenocarcinorna of the rectum and rectosigrnoid, 39 had a turnour which was considered locally non-resectable (19 patients) or borderline resectable (20 patients). Twenty-eight of these patients received radiation therapy with a daily target dose of 2 Gy up to a total of 46 Gy. If the turnour was still considered non-resectable 3 weeks later, radiation therapy was usually continued up to a total dose of 64 Gy together with 5-fluorouracil. Fifteen patients with a non-resectable turnour received radiation therapy up to a total dose of either 46 Gy (7 patients) or 64 Gy (8 patients). Only two patients underwent resection. Of the 20 patients with a turnour that was considered borderline resectable, 13 received 46 Gy. Nine patients in this group were radically resected. Totally 11 turnours were resected, constituting 39 per cent of the patients who were treated up to 46 Gy or more. Truly locally inoperable tumours in this series were thus rarely converted to extirpable tumours by means of radiation therapy. Most patients with a turnour considered borderline resectable seemed to benefit from the treatment. In addition, the palliative effect of radiation therapy was excellent.