Abstract
Preliminary results of complex treatment of patients with locally advanced rectal cancer with preoperative chemoradio- therapy (CRT) and consolidating chemotherapy (CT) are dis- cussed in the article. The study includes 89 patients of a stage T3 (CRM +) - 4N0-2M0 of the tumor process. In group “A” there was performed preoperative CRT in an isozedosis of 56 Gy against a background of CT by capecitabine 825 mg / m2 twice daily per os with consolidating CT (2 courses of XELOX). In group “B” there was conducted a similar treat- ment without consolidating CT. Group “A” consisted of 49 patients, group “B” - 40 patients. In 9 (18.4%) patients of group “A” a complete clinical response was diagnosed in the follow-up survey, which was the reason for abstinence from surgical treatment and they were taken for dynamic observa- tion. In 9 of 40 (22.5%) operated patients from group “A” there was noted a clinically significant complete morphologi- cal response in tumor (T0N0). In the control group “B” no complete clinical response was achieved in any patient. A complete morphological response in tumor was recorded in 5 of 40 (12.5%) (T0N0) operated patients. A 2-year recurrence- free survival in group “A” was 91.4%, in group B - 70.1%. Locoregional relapses, after treatment in group “A”, were not currently registered, in group “B” this indicator was 2.5%. The frequency of distant metastasis in the study groups was 2.1% and 7.5%, respectively. The average life expectancy was 13.1 months. Preliminary results confirmed strengthening of anti- cancer effect of consolidating CT after prolonged CRT, which was manifested in an increase in the frequency of complete clinical and morphological regression of tumor and, accord- ingly, an improvement of long-term results. A complete clinical response, achieved in every fifth patient, allowed refraining from a disabling operation and saved a quality of life.
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