Improved Sphincter Control for Rectal Cancer Patients

Chemotherapy and Radiation Therapy Before Surgery Leads to Improved Sphincter Control for Rectal Cancer Patients

Concurrent chemotherapy combined with preoperative radiation therapy for patients with advanced rectal cancer leads to improved sphincter preservation, according to a new study in the September 2003, issue of the International Journal of Radiation Oncology·Biology·Physics, the official journal of ASTRO, the American Society for Therapeutic Radiology and Oncology.

To better understand the contributions of concurrent chemotherapy to preoperative radiation therapy, researchers compared the outcomes of rectal patients who were treated at two large institutions " M.D. Anderson Cancer Center in Houston and Washington University School of Medicine in St. Louis. During the study, researchers reviewed the hospital and radiation records of 403 patients with clinically staged T3 or T4 adenocarcinoma of the rectum who were treated at one of the two institutions between 1978 and 1995 with preoperative radiation therapy followed by surgery. Of those patients, 215 received concurrent chemotherapy in addition to radiation and surgery. Senior attending surgeons with a focused practice in colorectal cancer performed the surgery at the two institutions and the staging workup was similar at both locations.

The findings of the study suggest that the addition of chemotherapy to preoperative radiation therapy in a standard fractionation scheme improves the tumor response to radiation therapy. The additional findings that the tumor response rate increased at Washington University after a policy change in which concurrent chemotherapy was added to radiation therapy also supports the notion that chemotherapy increases the objective tumor response to radiation therapy. These results allow for increased sphincter preservation in locally advanced rectal cancer patients.

"The use of concurrent chemotherapy with preoperative radiation therapy for patients with stage T3 and T4 rectal cancer independently increases the tumor response and may contribute to increase sphincter preservation for patients with low rectal cancer," said Christopher H. Crane, the lead author of the study and a member of the University of Texas M.D. Anderson Cancer Center Department of Radiation Oncology in Houston.

The American Society for Therapeutic Radiology and Oncology is the largest radiation oncology society in the world, with more than 7,000 members who specialize in treating patients with radiation therapies. As a leading organization in radiation oncology, biology and physics, the Society's mission is to advance the practice of radiation oncology by promoting excellence in patient care, providing opportunities for educational and professional development, promoting research and disseminating research results and representing radiation oncology in a rapidly evolving socioeconomic healthcare environment.