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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)

par Gerard, André ;Buyse, Marc;Nordlinger, Bernard;Loygue, Jean;Pene, Françoise;Kempf, Peter;Bosset, Jean François;Gignoux, Marc;Arnaud, Jean-Pierre;Desaive, Claude;Duez, Nicole
Référence Annals of surgery, 208, 5, page (606-614)
Publication Publié, 1988

Article révisé par les pairs

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Résumé :

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.