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. 1988 Nov;208(5):606–614. doi: 10.1097/00000658-198811000-00011

Preoperative radiotherapy as adjuvant treatment in rectal cancer. Final results of a randomized study of the European Organization for Research and Treatment of Cancer (EORTC).

A Gérard 1, M Buyse 1, B Nordlinger 1, J Loygue 1, F Pène 1, P Kempf 1, J F Bosset 1, M Gignoux 1, J P Arnaud 1, C Desaive 1, et al.
PMCID: PMC1493780  PMID: 3056288

Abstract

A randomized clinical trial was conducted by the European Organization for Research and Treatment for Cancer (EORTC) Gastrointestinal Cancer Cooperative Group to study the effectiveness of irradiation therapy administered in a dosage of 34.5 Gy, divided into 15 daily doses of 2.3 Gy each before radical surgery for rectal cancer (T2, T3, T4, NX, MO). Four hundred sixty-six patients were entered in the clinical trial between June 1976 and September 1981. Tolerance and side effects of preoperative irradiation were acceptable. The overall 5-year survival rates were similar in both groups. When considering only the 341 patients treated by surgery with a curative aim, the 5-year survival rates were 59.1% and 69.1% in the control group and in the combined modality group, respectively (p = 0.08). The local recurrence rates at 5 years were 30% and 15% in the control group and the adjuvant radiotherapy group, respectively (p = 0.003). Although this study did not show preoperative radiotherapy to have a statistically significant benefit on overall survival, it does have a clear effect on local control of rectal cancer. Therefore, before performing radical surgery, this adjuvant therapy should be administered to patients who have locally extended rectal cancer.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Balslev I., Pedersen M., Teglbjaerg P. S., Hanberg-Soerensen F., Bone J., Jacobsen N. O., Overgaard J., Sell A., Bertelsen K., Hage E. Postoperative radiotherapy in Dukes' B and C carcinoma of the rectum and rectosigmoid. A randomized multicenter study. Cancer. 1986 Jul 1;58(1):22–28. doi: 10.1002/1097-0142(19860701)58:1<22::aid-cncr2820580106>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
  2. Boulis-Wassif S., Gerard A., Loygue J., Camelot D., Buyse M., Duez N. Final results of a randomized trial on the treatment of rectal cancer with preoperative radiotherapy alone or in combination with 5-fluorouracil, followed by radical surgery. Trial of the European Organization on Research and Treatment of Cancer Gastrointestinal Tract Cancer Cooperative Group. Cancer. 1984 May 1;53(9):1811–1818. doi: 10.1002/1097-0142(19840501)53:9<1811::aid-cncr2820530902>3.0.co;2-h. [DOI] [PubMed] [Google Scholar]
  3. Brady L. W., Antoniades J., Prasasvinichai S., Torpie R. J., Asbell S. O., Glassburn J. R. Preoperative radiation therapy. A plan for combined therapy by the Radiation Therapy Oncology Group and the Central Oncology Group. Cancer. 1974 Sep;34(3):suppl–suppl:964. doi: 10.1002/1097-0142(197409)34:3+<960::aid-cncr2820340726>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]
  4. Buyse M., Zeleniuch-Jacquotte A., Chalmers T. C. Adjuvant therapy of colorectal cancer. Why we still don't know. JAMA. 1988 Jun 24;259(24):3571–3578. [PubMed] [Google Scholar]
  5. Cedermark B., Theve N. O., Rieger A., Wahren B., Glas J. E., Rubio C., Ost A., Broström L., Ekelund G., Forsgren L. Preoperative short-term radiotherapy in rectal carcinoma. A preliminary report of a prospective randomized study. Cancer. 1985 Mar 15;55(6):1182–1185. doi: 10.1002/1097-0142(19850315)55:6<1182::aid-cncr2820550607>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  6. Gerard A., Berrod J. L., Pene F., Loygue J., Laugier A., Bruckner R., Camelot G., Arnaud J. P., Metzger U., Buyse M. Interim analysis of a phase III study on preoperative radiation therapy in resectable rectal carcinoma. Trial of the Gastrointestinal Tract Cancer Cooperative Group of the European Organization for Research on Treatment of Cancer (EORTC). Cancer. 1985 May 15;55(10):2373–2379. doi: 10.1002/1097-0142(19850515)55:10<2373::aid-cncr2820551012>3.0.co;2-d. [DOI] [PubMed] [Google Scholar]
  7. Gunderson L. L., Sosin H. Areas of failure found at reoperation (second or symptomatic look) following "curative surgery" for adenocarcinoma of the rectum. Clinicopathologic correlation and implications for adjuvant therapy. Cancer. 1974 Oct;34(4):1278–1292. doi: 10.1002/1097-0142(197410)34:4<1278::aid-cncr2820340440>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
  8. Higgins G. A., Humphrey E. W., Dwight R. W., Roswit B., Lee L. E., Jr, Keehn R. J. Preoperative radiation and surgery for cancer of the rectum. Veterans Administration Surgical Oncology Group Trial II. Cancer. 1986 Jul 15;58(2):352–359. doi: 10.1002/1097-0142(19860715)58:2<352::aid-cncr2820580226>3.0.co;2-d. [DOI] [PubMed] [Google Scholar]
  9. Higgins G. A., Jr, Conn J. H., Jordan P. H., Jr, Humphrey E. W., Roswit B., Keehn R. J. Preoperative radiotherapy for colorectal cancer. Ann Surg. 1975 May;181(5):624–631. doi: 10.1097/00000658-197505000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Kligerman M. M., Urdaneta-Lafee N. Proceedings: Observations on fifteen inoperable-nonresectable cases of rectal cancer given preoperative irradiation. Am J Roentgenol Radium Ther Nucl Med. 1974 Mar;120(3):624–626. doi: 10.2214/ajr.120.3.624. [DOI] [PubMed] [Google Scholar]
  11. Mantel N. Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother Rep. 1966 Mar;50(3):163–170. [PubMed] [Google Scholar]
  12. Rich T., Gunderson L. L., Lew R., Galdibini J. J., Cohen A. M., Donaldson G. Patterns of recurrence of rectal cancer after potentially curative surgery. Cancer. 1983 Oct 1;52(7):1317–1329. doi: 10.1002/1097-0142(19831001)52:7<1317::aid-cncr2820520731>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  13. Stearns M. W., Jr, Deddish M. R., Quan S. H., Leaming R. H. Preoperative roentgen therapy for cancer of the rectum and rectosigmoid. Surg Gynecol Obstet. 1974 Apr;138(4):584–586. [PubMed] [Google Scholar]
  14. Tepper M., Vidone R. A., Hayes M. A., Lindenmuth W. W., Kligerman M. M. Preoperative irradiation in rectal cancer: initial comparison of clinical tolerance, surgical and pathologic findings. Am J Roentgenol Radium Ther Nucl Med. 1968 Mar;102(3):587–595. doi: 10.2214/ajr.102.3.587. [DOI] [PubMed] [Google Scholar]

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