Adjuvant Postoperative Radiation Therapy for Dukes C Adenocarcinoma of the Rectum

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Abstract
The effects of adjuvant postoperative radiation therapy on the course and survival of patients with Dukes C adenocarcinoma of the rectum were studied. Moderate dose radiotherapy was offered to 64 patients. A total of 24 accepted and were treated, while the remainder refused. With a mean follow-up of 32.3 mo., the overall survival rate was 63% (40/64), and the mean disease-free survival rate at the time of this report was 45%. The following variables were analyzed separately: operative procedure, distance of the tumor from the anal verge, tumor size, and transmural, vascular, lymphatic and perineural invasion of tumor. The most significant differences between irradiated and nonirradiated patients were found in the group of patients whose lesions were .ltoreq. 6 cm from the anal verge. Of the 19 such patients with an average follow-up of 36.4 mo., 10 patients were irradiated and 9 were not irradiated. The irradiated group had a 90% (9/10) survival rate and 70% (7/10) of them were disease free; the nonirradiated group had a 44% (4/9) survival rate and 22% (2/9) of them were disease free. Patients with adenocarcinoma of the rectum metastatic to lymph nodes, whose lesions'' lower border is measured .ltoreq. 6 cm from the anal verge, benefit significantly from adjuvant postoperative radiotherapy.