대한대장항문학회

<b>Purpose:</b> The aim of this study is to evaluate the effectiveness and surgical morbidity of preoperative chemoradiotherapy for locally advanced rectal cancer. <b>Methods:</b> Between December 1997 and March 2000, 36 patients with locally<br>advanced<br>rectal cancer (clinical stage II or III) were treated with preoperative chemoradiation: bolus i.v. leucovorin, 20 ㎎/㎡, plus 24-h continuous infusion i.v. 5-Fluorouracil, 425 ㎎/㎡, Days 1∼5, 29∼33 and concurrent radiotherapy 4,500 cGy over 5<br>weeks.<br>Surgery was performed 4∼8 weeks after completion of the chemoradiotherapy. <b>Results:</b> Grade 3∼4 toxicity during chemoradiotherapy was low: hematological toxicities 2.8%, gastro-intestinal toxicities 5.5% and skin toxicities 8.3%. Complete<br>response rate was 16.7% and partial response rate was 47.2%, the rate of downstaging for tumor was 65.5%. The overall rate of resectability was 94.1%. In 13 of 22 (59.1%) patients planned APR, the sphincter was preserved. The overall rate of<br>surgical<br>morbidity was 23.5%, but there was no postoperative mortality. One patient needed a reoperation because a complication may be associated with preoperative chemoradiotherapy. <b>Conclusions:</b> Preoperative chemoradiotherapy for locally advanced<br>rectal<br>cancer seems to afford some potential advantages: patients are able to tolerate higher chemotherapy doses with low toxicities; tumor downstaging and resectability rates are high; sphincter preservation is feasible; But perioperative morbidity has<br>generally tolerable complications. And so we recommend the preoperative chemoradiotherapy may be one of the best treatments for locally advanced rectal cancer.<br>