The Postoperative Adjuvant Radiation Therapy and Radiochemotherapy for UICC Stage II and III Rectal Cancer A Retrospective Analysis

Abstract

Prognosis of patients with UICC Stage III rectal cancer remains poor after "standard" surgery followed by postoperative adjuvant treatment (pelvic radiotherapy and bolus intravenous injection of 5-FU and leucovorin). Major efforts should be made in order to improve prognosis for these patients, including optimization of surgical treatment and systemic treatment. More effective multimodality treatment strategies should be investigated in prospective randomized trials.

Intensified concurrent chemoradiotherapy with 5-fluorouracil and irinotecan as neoadjuvant treatment in patients with locally advanced rectal cancer

“…The size of the problem related to distant metastasis in locally advanced rectal cancer becomes even more evident if one considers not only selected study populations but also consecutive patient series in everyday practice. In a retrospective analysis of patients who received adjuvant chemoradiotherapy with 5-fluorouracil and folinic acid at the University of Würzburg, Germany, distant failures occurred in as much as 49% of stage III patients (Bagatzounis et al, 2000). Although the patients in our phase II study had comparatively large, advanced tumours, only 24% developed distant metastasis, and among those with R0 resection the rate was as low as 14%.…”

High Survivin Expression is Associated with Reduced Apoptosis in Rectal Cancer and May Predict Disease-Free Survival after Preoperative Radiochemotherapy and Surgical Resection

“…Postoperative radiochemotherapy has been recommended in patients with locally advanced rectal cancer (UICC stage II and III) [15,32] and is standard of care in the US and in Germany outside clinical trials [4,32]. In recent years mounting evidence has been accumulated that preoperative administration of radiation therapy may offer certain advantages over delivering radiation therapy postoperatively [7,11,16,21,23,44,49].…”

Restaging of Locally Advanced Carcinoma of the Rectum with MR Imaging after Preoperative Radio-Chemotherapy plus Regional Hyperthermia

“…Adjuvant radiochemotherapy after curative resection is the standard treatment for locally advanced rectal carcinoma pT3/4 or pN+ [3]. While it is unquestionable that (postoperative) radiotherapy reduces local recurrencies, its influence on overall survival is still under discussion [33].…”