PREOPERATIVE OR POSTOPERATIVE RADIATION-T HERAPY IN RECTAL-CARCINOMA

Purpose: To compare the results of preoperative and postoperative radi otherapy in rectal adenocarcinoma, in terms of overall survival and di sease-free survival. Patients and methods: From 1989 to 1993, 52 patie nts with clinically operable rectal cancer were retrospectively analiz ed. Two groups were compared: Patients in Group I received postoperati ve radiotherapy and those in Group II preoperative radiotherapy, Patie nts with a Karfnosky index > 70%, no evidence of distant disease and n o major sistemic problems were included in this study. Results: The ov erall 5-year actuarial survival was 75% in Group I and 83% in Group II . The 5-year disease-free survival was 52% in Group I compared to 86% in Group II, a statistically significant difference (p=0.025). A reduc tion in all Dukes' stages was observed in the preoperative radiation g roup, allowing preservation of the anorectal function in an increased number of patients. Conclusions: We observed better results with preop erative radiotherapy and conclude that this treatment might be justifi ed in rectal carcinoma.