The use of radiation therapy combined with chemotherapy in the management of XXXX and marginally resectable @entity188 .

@entity1 @entity5 @entity1138 @entity957 @entity189 @entity188 @entity5584 @entity1487
For many years surgery has been the treatment of choice for @entity957 , but it is now becoming apparent that well-planned definitive radiation therapy combined with chemotherapy may obviate the need for an abdomino-perineal resection. Since 1976, 33 @entity1 with this disease were treated at Highland Hospital by radiation therapy combined with @entity1487 and @entity1138 for sensitization. Four of these @entity1 underwent a planned abdomino-perineal resection following therapy; the operative specimens of all four @entity1 were negative for @entity5 . Twenty-nine @entity1 were treated by the above method without surgery in a definitive manner and local control was achieved in 89.6% of @entity1 . Radiation therapy combined with @entity1487 and @entity1138 for sensitization has also been used in an effort to improve the resectability rate of large @entity5 and ultimately the 5-year survival of @entity1 with this disease. Fifty-eight @entity1 with marginally resectable @entity188 were treated pre-operatively by this regimen. The method of administration of the chemotherapeutic agents used for sensitization appears to be an important factor in obtaining an increased therapeutic ratio. Thirty-three @entity1 have been followed for a minimum of 5 years with an 84.9% local control rate; 63.7% are alive and well, and 9.1% have died of intercurrent disease. An additional 22 @entity1 have been treated with this regimen for recurrent @entity5584 and 9.9% are alive and well at 5 years. Radiation therapy combined with @entity1487 and @entity1138 for sensitization purposes appears to be effective in downstaging @entity189 at surgery with a resultant survival rate superior to that following surgery alone.
