Role of neoadjuvant radio-chemotherapy for the treatment of high rectal cancer

Maxi Treder, Stefan Janssen, Niels Henrik Holländer, Steven E. Schild, Dirk Rades*

*Corresponding author for this work
3 Citations (Scopus)


Background/Aim: Controversy exists regarding treatment of high rectal cancer. The role of neoadjuvant radio-chemotherapy was investigated. Patients and Methods: Fifty-four patients receiving neoadjuvant radio-chemotherapy (50.4 Gy & 2 courses of concurrent chemotherapy) for stage II/III high rectal cancer (10.1-15.0 cm from anal verge) were retrospectively analyzed. Following microscopicallly complete resection of primary tumor and involved lymph nodes in all patients, ≤6 courses of chemotherapy were given. Results: Five-year rates of local control (LC), metastases-free survival (MFS) and overall survival (OS) were 90%, 79% and 77%. On multivariate analyses, LC was associated with lower pathological UICC-stage at surgery (p=0.003) and successful downstaging (p=0.007), MFS with higher regression grade (p=0.014) and OS with lower Union for International Cancer Control (UICC)-stage (p=0.017) and downstaging (p=0.034). Grade 3 acute toxicities occurred in 19% of patients; grade ≥3 late toxicities were not observed. Manageable surgery-related complications occurred in 43%. Conclusion: Neoadjuvant radio-chemotherapy for high rectal cancer was well tolerated and led to promising results. Comparative studies are required to investigate whether it is superior to postoperative chemotherapy alone.

Original languageEnglish
JournalAnticancer Research
Issue number9
Pages (from-to)5371-5377
Number of pages7
Publication statusPublished - 09.2018


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