Publication:

Role of neo-adjuvant chemo - radiotherapy in colorectal malignancy

Background Adenocarcinoma of the colon and rectum is one among most common site of new cancer cases and deaths in both men (following prostate and lung/bronchus) and women (following breast, cervix and lung/bronchus). The objective of this study was to evaluate the usefulness of neoadjuvant chemo-radiotherapy in colorectal carcinoma.

Methods This study has been conducted in the department of surgery, Govt. Rajaji hospital, Madurai during 2008-2009. 20 patients were subjected to detailed history, thorough clinical examination of the abdomen, digital rectal examination, proctoscopy, and scopy guided biopsy was taken for histopathological examination.

Results All patients were subjected to chemo-radiotherapy for 6weeks, followed by surgery. 20% of the patients underwent low anterior resection, 35% of patients underwent anterior resection, 35% of the patients underwent abdomino-perineal resection, 10% had undergone loop colostomy. Out of the 20 patients 2 female patients had posterior vaginal wall fixity which following CRT underwent APR without resection of the posterior vaginal wall.

Conclusions Neoadjuvant therapy may be considered a rational approach for treatment of curative rectal cancer. Volumetric reduction of neoplasia, mesorectum and lateral pelvic nodes was evident in 90% of the patients.