Successful resection of locally advanced rectal carcinoma combined with preoperative chemoradiation

Chemoradiation increases the local control and colostomy-free survival in patients with advanced anal canal carcinomas., We recently experienced a 50-year-old female patient with locally-advanced carcinoma of the rectum invading to that sacrum, which could not be,surgically resected. Therefore, we performed a colostomy, and, transarterial, infusion of anti-tumor drugs inducing 50mg cisplatin and 10mg mitomycin C via the inferior mesentery artery in September 1999. She then underwent radiotherapy with a total dose. of, 64 Gy for the primary tumor. After the radiotherapy the patient received 125mg/body of 1-leucovorin by 2 hour infusion and, one hour after starting the 1-leucovorin infusion, she received an intravenous bolus of 250mg/body of 5-fluorouracil. This regimen was conducted biweekly for 13 courses followed by oral administration of 400mg 5'-deoxyfluorouridine for one year. Since the chemoradiation resulted in a successful response, the patient underwent curative resection of the primary tumor in June 2001. The resected tumor (32x35mm) had clean margins. Although the carcinoma cells had disappeared, fibrous lesions were observed over a broad area. Based on these pathologic findings, the treatment effect was judged as grade Ib.