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학술저널
저자정보
Lee, Jeong Won (Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) Lee, Jong Hoon (Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) Kim, Jun-Gi (Department of Colorectal Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) Oh, Seong Taek (Department of Colorectal Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) Chung, Hyuk Jun (Department of Colorectal Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) Lee, Myung Ah (Department of Medical Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) Chun, Hoo Geun (Department of Medical Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) Jeong, Song Mi (Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) Yoon, Sei Chul (Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic Un) Jang, Hong Seok
저널정보
대한방사선종양학회 Radiation oncology journal : ROJ Radiation oncology journal : ROJ 제31권 제3호
발행연도
2013.1
수록면
155 - 161 (7page)

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Purpose: To evaluate the treatment outcomes of preoperative versus postoperative concurrent chemoradiotherapy (CRT) on locally advanced rectal cancer. Materials and Methods: Medical data of 114 patients with locally advanced rectal cancer treated with CRT preoperatively (54 patients) or postoperatively (60 patients) from June 2003 to April 2011 was analyzed retrospectively. 5-Fluorouracil (5-FU) or a precursor of 5-FU-based concurrent CRT (median, 50.4 Gy) and total mesorectal excision were conducted for all patients. The median follow-up duration was 43 months (range, 16 to 118 months). The primary end point was disease-free survival (DFS). The secondary end points were overall survival (OS), locoregional control, toxicity, and sphincter preservation rate. Results: The 5-year DFS rate was 72.1% and 48.6% for the preoperative and postoperative CRT group, respectively (p = 0.05, the univariate analysis; p = 0.10, the multivariate analysis). The 5-year OS rate was not significantly different between the groups (76.2% vs. 69.0%, p = 0.23). The 5-year locoregional control rate was 85.2% and 84.7% for the preoperative and postoperative CRT groups (p = 0.98). The sphincter preservation rate of low-lying tumor showed significant difference between both groups (58.1% vs. 25.0%, p = 0.02). Pathologic tumor and nodal down-classification occurred after the preoperative CRT (53.7% and 77.8%, both p < 0.001). Acute and chronic toxicities were not significantly different between both groups (p=0.10 and p = 0.62, respectively). Conclusion: The results confirm that preoperative CRT can be advantageous for improving down-classification rate and the sphincter preservation rate of low-lying tumor in rectal cancer.

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