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KMID : 0670720000050040017
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Journal of the Korean Society Hyperthermia Oncology
2000 Volume.5 No. 4 p.17 ~ p.25
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Multivariate Analysis of Preopertive Radiochemotherapy and Hyperthermia in the Treatment of Resectable Rectal Cancer
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Kim Myung-Se
Kim Sung-Kyu
Sakong Joon
Lee Ho-Jun
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Abstract
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Purpose: To evaluate the effect of preoperative radiochemotherapy±hyperthermia on survival and prognostic factors in the treatment of resectable rectal cancer patients.
Materials & Methods: One hundred and fourty seven patients with histologically proven rectal cancer from march 1996 to march 1999 were analyzed retrospectively. All patients had radiotherapy (30-40Gy with 180cGy/5times/week) and 76.9% of
patients treated with chemotherapy(5FU 425 ㎎/㎡, Leucovorin 30 ㎎, Mitomycin 10 ㎎/㎡) but only 43 patients(29.3%) had hyperthermia treatment(40 minutes>39.5℃). Ninety eight percentage of patients had adenocarcinoma and stage Ⅱ was reported in 61.9% of patients. Low anterior resection was performed in 55.8% of patients and abdominoperineal resections in 12.9%. Survival was investigated by patients and abdominoperineal resections in 12.9%. Survival was investigated by uni- and multivariate analyses according to T stage, lymphnode status, number of chemotherapy, total radiation dose, type of resection and hyperthermia treatment.
Results: Overall 4 year survival rate in radiochemotherapy and plus hyperthermia group were 78% and 95%(p=0.02). In multivariate Cox-regression analysis, stage(p=0.48), sex(p=0.08), Tstage(p=0.28), type of operation(p=0.36), numbers of
chemotherapy(p=0.38), total dose of radiation(p=0.23), numbers of lymph node and complications(p=0.25) were not significant prognostic factors. Hyperthermia treatment was the only factor of significantce(p=0.04) on survival rate.
Conclusions: Hyperthermia treatment was the only significant factor which was effective on survival in uni- and multivariate analyses for resectable rectal cancer patients. These data suggested that hyperthermia should be considered as the effective treatment for resectable rectal cancer.
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KEYWORD
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resectable rectal cancer, radiochemotherapy, hyperthermia, survival, multivariate analysis,
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