Survival following preoperative radiation therapy with injection of anti-cancer drugs for carcinoma of the rectum

We performed a retropsective study of patients with carcinoma of the rectum who had undergone surgical resection and preoperative radiation therapy. Twenty-one surgically treated patients with carcinoma of the rectum (Group 3) were treated with preoperative radiotherapy and intratumoral injection of peplomycin and BUdR (5-bromo-2'-deoxyuridine). On the other hand, 25 patients (Group 1) were treated by surgery alone and 15 patients (Group 2) were treated with preoperative radiotherapy alone. Differences in the background factors of the patients in the three groups were not significant. The total dose of preoperative radiation was 42.6 Gy, i. e., 30.6 Gy(1.8 Gy/fr x 5/wk) delivered to the entire pelvis plus an additional 12 Gy(3.0 Gy/fr x 4/wk) to the primary tumor. Results : About 30 % of the patients in Group 3 had a slight fever of 38 - 38.5 deg C after injection therapy, but this subsided completely the following morning without any treatment. Comparing the three groups, there was no significant difference in other preoperative and postoperative complications. The recurrence rate was 52.0 % in Group 1, 20.0 % in Group 2 and 23.8 % in Group 3. In Groups 2 and 3, the local recurrence was remarkably decreased compared with that in Group 1. The cumulative 5-year survival was 56.0 % in Group 1, 69.2 % in Group 2 and 77.8 % Group 3. (author)