Regarding Clinical Response, Neoadjuvant Chemoradiation is More Effective than Neoadjuvant Radiation alone in the Treatment of Advanced Stage (Stage II and III) of Rectal Carcinoma

Colorectal cancer is one of the leading cause of cancer death in male women in the world. Though surgery is the mainstay of treatment but there is a potential and important role of adjuvant therapies in the management of advanced rectal cancer. Neoadjuvant chemoradiation has been shown significantly decrease the local tumour size as well as local recurrence and become an standard option in the management of advanced stage of rectal cancer. An observational prospective hospital based study was done to compare the clinical response and acute adverse effects of neoadjuvant chemoradiation with that of standard treatment. A total of 90 eligible patients with histopathologically proven adenocarcinoma and radiologically staged stage II and stage III rectal cancer, were enrolled in this study.45 patients in arm A was treated with 45 Gy in 25 fractions combined with inj.5-FU 225mg/m2 daily during RT. And on the other hand 45 patients in arm B received 45 Gy in 25 fractions only. Comparing the clinical response by symptom relief and decrease of tumour size between these two arms. Out of 90 enrolled patients, 61.67% were male and 38.33% were female. Mean age was 43.65? 10.24 years. Majority of the patients (60%) were in stage III rectal carcinoma. Regarding improvement of clinical symptoms Arm A showed more response than Arm B. Observed treatment related toxicities were acceptable in both Arm. Conclusion: The neoadjuvant chemoradiation with 45 Gy in 25 fractions combined with inj.5-FU 225mg'm2 showed improved clinical response and more local control compared with neoadjuvant radiation alone (45 Gy in 25 fraction).