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Cancer blog: Pre-operative chemo-radiation Prevents Local Relapse of Rectal Cancer

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Oct 15, 2005

Pre-operative chemo-radiation Prevents Local Relapse of Rectal Cancer

Pre-operative Chemo-radiation Prevents Local Relapse of Rectal Canceriv chemotherapyPre-operative combination of chemotherapy and radiation may improve outcomes in rectal cancer as per a recent study by German researchers. These researchers working with 26 different hospitals randomly assigned a total of 799 patients with clinical stage II or stage III rectal cancer to receive chemo-radiation either before or after surgery using the drug 5-FU.

Patients in the before-surgery group completed chemoradiation treatment six weeks before surgery. Those in the other group had surgery first, followed by the same chemoradiation regimen, except for a radiation boost delivered to the area where the tumor was removed. Afterwards, patients in both groups received additional treatment with 5-FU.

After a median follow-up period of just under four years, six percent of patients in the before-surgery group had had a local relapse, compared with 13 percent in the after-surgery group. Similar numbers of patients in both groups (36 percent for the before-surgery group; 38 percent for the after-surgery group) had a relapse elsewhere in the body.

Overall survival at five years was 76 percent for the before-surgery group and 74 percent for the after-surgery group. However, this difference was not statistically significant.

Overall, fewer patients in the before-surgery group suffered severe short-term or long-term side effects of treatment, such as diarrhea and the development of narrowings where the bowel was reconnected after removal of the tumor.

Some patients at the start of the trial had tumors that surgeons thought would require the complete removal of the rectum; this, in turn, would require a permanent colostomy (that is, creation of an opening in the wall of the abdomen to allow removal of waste from the body). Among these patients, the before-surgery group was more likely to avoid a colostomy - their rate of bowel reconnection after tumor removal was more than double that of the after-surgery group.

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Cancer blog: Pre-operative chemo-radiation Prevents Local Relapse of Rectal Cancer

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