Radical external beam radiation therapy for adenocarcinoma of the rectum

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Abstract
External beam megavoltage radiation therapy was used as primary treatment for 123 patients with rectal adenocarcinoma. Surgery was undertaken for some patients who had residual tumor. The overall 5-yr survival rate was 21%. When patients were separated into those who presented with clinically mobile and those with clinically fixed rectal tumor masses, the survival rates were 38% and 2%, respectively. The primary tumor was controlled by radiation alone in 21 of 56 (38%) patients who had mobile tumors but in only 6 of 67 (9%) patients who had fixed tumors. Further investigation of high-dose primary radiation, with surgery reserved for patients with residual rectal carcinoma, may allow reduction of the number of patients who require abdominoperineal resection.