Efficacy and toxicity of postoperative chemo-radiation in treating rectal cancer after laparoscopic resection

Chen Xialin; Sun Caiping; Wang Jianfang

doi:10.3760/cma.j.issn.1673-4777.2016.01.019

Abstract：Objective To evaluate the efficacy and toxicity of postoperative chemoradiation in treating rectal cancer after laparoscopic resection.Methods Eighty six elderly patients with stage Ⅱ and Ⅲ rectal cancer after laparoscopic resection from January 2008 to January 2012 were randomly divided into simple radiotherapy group (43 cases) treated with three dimensional conformal radiotherapy and synchronous chemoradiation group (43 cases) treated with three-dimensional conformal radiotherapy combined with capecitabine chemotherapy.The 3 years total survival rate, 3 years local recurrence rate, 3 years transfer rate were compared between the two groups;the adverse reactions were also observed.Results The 3 years total survival rate was significantly higher and the 3 years local recurrence rate was significantly lower in synchronous chemoradiation group compared with those in simple radiotherapy group [90.7％ (39/43) vs 76.7％ (33/43), 4.7％ (2/43) vs 14.0％ (6/43)] (x2 =4.11,4.58, both P ＜ 0.05);there was no statistical difference of distant metastasis rate between the two groups (x2 =0.52, P ＞ 0.05).The incidences of leucopenia and diarrhea were significantly higher in synchronous chemoradiation group than those in simple radiotherapy [58.1％ (25/43) vs 34.9％ (15/43), 44.2％ (19/43) vs 14.0％ (6/43)] (P ＜ 0.05), while there were no statistical differences regarding nausea and vomiting, thrombocytopenia and radioactive enteritis (P ＞ 0.05).Conclusion Postoperative synchronous chemo-radiation can obviously improve the 3 years overall survival rate and reduce the 3 years local recurrence rate with good toleration in elderly patients with stage Ⅱ and Ⅲ rectal cancer after laparoscopic resection.