Adverse effects of combined radiochemotherapy in management of inoperable rectosigmoid carcinoma

Local tumor response and survival were assessed together with therapy tolerance and possible sequelae in a study comparing a new method of combined radiotherapy (4-field technique) and chemotherapy with radiotherapy alone, of inoperable rectosigmoid carcinoma. 36 patients were administered radiotherapy and 5-fluorouracil in combination and subsequent chemotherapy. 20 patients treated for similar indications with radiotherapy alone were assessed as controls. The use of the combination method resulted in an increase of primary local tumor response from 25% to 66%, of which complete remissions were in a ratio of 11:5 and partial remissions in a ratio of 55:20. Survival curves were more favorable in the first 34 months for the combination method; after that time, they were similar for both groups. Improved primary therapeutical results, however, were accompanied by increased incidence of acute side effects, such as nausea and vomiting (42%), leukopenia (27%), diarrhea (22%) and stomatitis (3%) which were dose-related. Serious adverse reactions were not observed. (L.O.). 2 tabs., 5 refs