The Role of Radiation Therapy on Local Recurrence of Rectal Cancer

다국어 초록 (Multilingual Abstract)

Ninety five patients of rectal cancer treated with surgery with or without adjuvant radiation therapy since January 1982 to December 1990 at the Chonnam University Hospital were analysed retrospectively regarding local failure. Of these 95 patients 72 patients were treated with surgery alone and remaining 23 patients received postoperative radiation therapy to pelvis. There were 45 men and 50 women with 53 years of median age. Minimum follow-up period was 19 months and median was 47 months (range, 19-125 months). Kaplan-Meier method was used to calculate actuarial risk of local recurrence and survival rate. Comparison between two groups was evaluated by Log rank test.
Of total 95 patients twenty seven patients (28.4%) developed local recurrence and 13 patients (17.3%) developed local and distant metastasis concomitantly. Eighty nine percent (24/27) of patients developed local recurrence within 24 months. Pelvic organ adjacent to the primary tumor area was the most common site of initial local recurrence.
Of 72 patients treated with surgery alone local recurrence developed in 24 patients. Of 17 patients with stage A and B1(Gunderson - Sosin modification of Dukes' staging system) 6 patients experienced local recurrence (31.2%). The local recurrence rate of B2 and B3 group was 29.9% (7/33) and that of C2 and C3 was 54.7% (11/19), respectively. There was statistically significant difference between two groups (p<0.05). Of 23 patients treated with definitive surgery and radiation therapy 10% (1/10) recurred in B2 and B3 patients. This was slightly lower than C2 and C3 patients (22.2%, 2/10) of similar policy, but revealed no statistically significant difference (p>0.05). In the patients of B2+3 local failure rate decreased when radiation therapy was added (29.9%) vs 10%, p>0.05) and also similar results in C2+3 group (34.7% vs 22.2%, p<0.05). The local failure rate in relation to distance from the anal verge had verge had no statistically significant difference.