Results of external beam radiotherapy alone for incompletely resected XXXX of rectosigmoid or rectum: Peter MacCallum Cancer Institute experience 1981-1990.

@entity1 @entity5 @entity189 @entity66
PURPOSE: To study the results of external beam radiotherapy treatment for incompletely resected nonmetastatic rectosigmoid and @entity189 . METHODS AND MATERIALS: A retrospective review was carried out of all @entity1 (57) presenting to Peter MacCallum Cancer Institute from 1981 to 1990 with incompletely resected nonmetastatic rectosigmoid or @entity5 who were treated with external beam radiotherapy. Three radiotherapy schedules were used: radical (50 to 60 Gy, 27 @entity1 ), high-dose palliative (45 Gy, 25 @entity1 ), and low-dose palliative (less than 45 Gy, 5 @entity1 ). Symptomatic response, overall survival, and the effect of prognostic factors on treatment outcome were evaluated. The median follow-up period for survivors was 49 months. RESULTS: Symptomatic response rates were 83% and 79% for the radical and high-dose palliative groups respectively. The estimated median survival time from presentation for all @entity1 was 16.4 months (radical 26.1 months, high-dose palliative 15.7 months). @entity1 with microscopic @entity66 survived significantly longer than @entity1 with macroscopic @entity66 (estimated median survival time 30.7 months vs. 14.3 months, p = 0.013). CONCLUSIONS: No dose response effect was seen between the radical group and high-dose palliative group. Microscopic @entity66 at presentation was the only significant predictor of better survival. The conventionally fractionated course of 50 to 60 Gy was not significantly better in terms of palliation and overall survival than a shorter palliative course of 45 Gy. In future, preoperative chemoradiation should improve outcome by reducing the number of @entity1 with incompletely resected @entity5 .
