Short–term effects of neoadjuvant chemoradiation therapy on anorectal function in rectal cancer patients: a pilot study

Radiation Oncology

Hyeon-Min Cho²  Nan-Sook Lee²  Byoung-Yong Shim⁴  Sung-Hwan Kim³  Jun-Gi Kim¹  Hyung-Jin Kim²  Bong-Hyeon Kye² 

[1] Department of Surgery, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea;Department of Surgery, St. Vincent Hospital, The Catholic University of Korea, Suwon, Korea;Department of Radiation Oncology, St. Vincent Hospital, The Catholic University of Korea, Suwon, Korea;Department of Medical Oncology, St. Vincent Hospital, The Catholic University of Korea, Suwon, Korea

关键词: Rectal cancer;    Manometry;    Neoadjuvant chemoradiation;    Anorectal function;   

Others  :  1153127
DOI  :  10.1186/1748-717X-8-203

 received in 2013-01-08, accepted in 2013-08-16,  发布年份 2013

【 摘 要 】

Background

Neoadjuvant chemoradiation therapy followed by curative surgery has gained acceptance as the therapy of choice in locally advanced rectal cancer. However, deterioration of anorectal function after long-course neoadjuvant chemoradiation therapy combined with surgery for rectal cancer is poorly defined. The aim of this study was to evaluate the physiological and clinical change of anorectal function after neoadjuvant chemoradiation therapy for rectal cancer.

Methods

We analyzed 30 patients on whom preoperative anorectal manometry data were available both before and after chemoradiation from October 2010 to September 2011. All patients underwent long-course neoadjuvant chemoradiation therapy. We compared manometric parameters between before and after neoadjuvant chemoradiation therapy.

Results

Of 30 patients, 20 were males and 10 females. The mean age was 64.9 ± 9.9 years (range, 48-82). Before nCRT, the rectal compliance was higher in patients with ulceroinfiltrative type (P = 0.035) and greater involvement of luminal circumference (P = 0.017). However, there was the tendency of increased rectal sensory threshold for desire to defecate when the patient had decreased circumferential ratio of the tumor (P = 0.099), down-graded T stage (P = 0.016), or reduced tumor volume (P = 0.063) after neoadjuvant chemoradiation.

Conclusions

Neoadjuvant chemoradiation therapy did not significantly impair overall sphincter function before radical operation. The relationship between tumor response of chemoradiation and sensory threshold for desire to defecate may suggest that neoadjuvant chemoradiation may be helpful for defecatory function as well as local disease control, at least in the short-term period after the radiation in locally advanced rectal cancer patients.

【 授权许可】

   
2013 Kye et al.; licensee BioMed Central Ltd.

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