ABDOMINOPERINEAL RESECTION COMBINED WITH PREOPERATIVE AND POSTOPERATIVE RADIATION-THERAPY IN THE TREATMENT OF LOW-LYING RECTAL-CARCINOMA

Purpose: A series of patients with rectal carcinoma irradiated by a sa ndwich technique combined with surgery is retrospectively analyzed. Me thods and Materials: From 1978 to 1991, 155 patients with low or mid r ectal carcinoma received abdominoperineal resection combined with a pr eoperative irradiation regimen of 35 Gy delivered in 14 fractions of 2 .5 Gy each over a period of 3.5 weeks, The dose was increased to 45 Gy in the case of tumor fixation, According to histopathological finding s, this irradiation was complemented in 87 cases by a postoperative do se of 25 Gy delivered in 10 fractions, for a total dose of 60 Gy deliv ered in the posterior pelvis. Results: Five-year survival was 66.8 % f or the entire population, The 5-year actuarial local control rate was 77.6 %. Carcinologic results and toxicity were analyzed according to t he pathological findings and the modalities of radiation therapy. Conc lusions: The postoperative boost after a preoperative moderate dose of irradiation seems to have no utility, Thus, this sandwich technique i s not recommended. Copyright (C) 1997 Elsevier Science Inc.