BACKGROUND: To analyze early results of a single institution's experience using neo-adjuvant chemoradiotherapy in locally advanced, ultrasound-staged @entity5 . @entity1 AND METHODS: Since 1998, 67 consecutive @entity1 (36 males and 31 females; mean age, 59.5) have received preoperative combined treatment for T3 or T4 @entity5 . All @entity1 were staged by endorectal ultrasound and computed tomography, and all had a pathology-demonstrated invasive @entity188 . @entity1 were treated preoperatively with concomitant radiochemotherapy: pelvic irradiation (50 Gy in 25 fractions) and protracted-venous-infusion @entity1487 (225 mg/m2/d, 7 days per week). @entity1 were restaged within 4 weeks, then submitted to surgery within 6-7 weeks after the end of therapy. Adjuvant postoperative chemotherapy with @entity1487 plus @entity4181 --the "de Gramont" schedule--for 24 weeks was purposed to all @entity1 . RESULTS: Radiotherapy was completed in all cases; only one @entity1 required suspension of the treatment for grade 4 @entity137 ( @entity294 ). Instead, chemotherapy was interrupted in 3 cases (2 for central @entity49 and 1 for grade IV @entity294 ). Sixty-six @entity1 underwent surgical resection (1 @entity1 died before surgical treatment). Radical surgery was performed in 94%, and 46% of the 26 @entity1 with @entity5 had a conservative sphincter-sparing surgery. A complete pathologic response (defined as no evidence of viable @entity5 cells) was obtained in 22%. At a median follow-up of 17 months, distant @entity3 have been observed in 10 @entity1 , and 3 of them developed a local recurrence. The actuarial estimations of 4-year overall survival, disease-free survival, local and distant control are 79%, 61%, 94% and 61%, respectively. CONCLUSIONS: Preoperative chemoradiotherapy seems to be an effective and well-tolerated treatment with a low complication rate. The high percentage of down-staging and sphincter sparing, also in @entity5 , shows the efficacy of the treatment, which could significantly influence the incidence of relapses and quality of life.

Preoperative concomitant radiotherapy and chemotherapy in ultrasound-staged T3 and T4 XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'PATIENTS'] @entity4181 :: ('MESH:D002955', 'Chemical') :: ['folinic acid'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'distal rectal cancer', 'rectal cancer'] @entity294 :: ('MESH:D003967', 'Disease') :: ['diarrhea'] @entity49 :: ('MESH:D019851', 'Disease') :: ['venous catheter thrombosis'] @entity188 :: ('MESH:D012004', 'Disease') :: ['adenocarcinoma of the rectum'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases'] @entity1487 :: ('MESH:D005472', 'Chemical') :: ['5-fluorouracil']
@entity5 :: (MESH:D009369,Disease) :: ['rectal cancer']
