Cedermark B, Theve N O, Rieger A, Wahren B, Glas J E, Rubio C, Ost A, Broström L, Ekelund G, Forsgren L
Cancer. 1985 Mar 15;55(6):1182-5. doi: 10.1002/1097-0142(19850315)55:6<1182::aid-cncr2820550607>3.0.co;2-7.
Between 1980 and 1983, 373 patients with clinically resectable rectal adenocarcinoma entered a prospective randomized study aimed to evaluate the effect of short-term preoperative radiotherapy. Protocol violations were identified in 21 instances. Of the remaining 352 patients, 182 were randomized to surgical treatment only (S-group). Immediately, before surgery, 170 patients were irradiated to the pelvic region with 25 Gy (2500 rad) during a 5-day period (RT-group). Of these patients, 59% underwent abdominoperineal excision, 38% anterior resection, and 3% laparotomy only. At surgery distant metastases were discovered in 32 patients (9%). There were no significant differences between the groups in the distribution of age, sex, operative methods, and tumor stage according to the original Dukes' classification. During the follow-up time, ranging between 6 months and 3 years, tumor recurrence occurred in 35 patients, 19 in the S-group and 16 in the RT-group. Fifteen patients in the S-group had pelvic recurrence compared to 10 patients in the RT-group. Distant metastases occurred in six and eight patients, respectively. Two patients in each group had both pelvic and distant recurrence. There was no correlation between tumor recurrence and type of operation. Median time interval from diagnosis to pelvic recurrence was 10 months in the S-group and 16 months in the RT-group. Postoperative complications in the form of wound sepsis were slightly more common in the RT-group. In summary, the applied treatment regimen, is well-tolerated and apparently does not affect the Dukes' stage of the tumor. Although there is no statistically significant difference, there is a trend of less pelvic recurrence in patients receiving preoperative radiotherapy.
1980年至1983年间，373例临床可切除的直肠腺癌患者进入一项前瞻性随机研究，旨在评估短期术前放疗的效果。发现21例违反方案的情况。在其余352例患者中，182例被随机分配至仅接受手术治疗组（S组）。在手术前即刻，170例患者在5天内接受盆腔25 Gy（2500 rad）的照射（放疗组，RT组）。这些患者中，59%接受了腹会阴切除术，38%接受了前切除术，3%仅接受了剖腹术。手术时发现32例患者（9%）有远处转移。两组在年龄、性别、手术方式以及根据原Dukes分期的肿瘤分期分布上无显著差异。在6个月至3年的随访期间，35例患者出现肿瘤复发，S组19例，RT组16例。S组15例患者出现盆腔复发，而RT组为10例。远处转移分别发生在6例和8例患者中。每组各有2例患者同时出现盆腔和远处复发。肿瘤复发与手术类型之间无相关性。S组从诊断到盆腔复发的中位时间间隔为10个月，RT组为16个月。RT组伤口感染形式的术后并发症略为常见。总之，所应用的治疗方案耐受性良好，显然不影响肿瘤的Dukes分期。尽管无统计学显著差异，但接受术前放疗的患者盆腔复发有减少的趋势。
