Organ saving treatment of low rectal cancer
The objective is to study the treatment results of patients with low rectal cancer with complete tumor regression after neoadjuvant chemoradiation (CRT) and consolidating chemotherapy. Materials and methods. The investigation involved 70 patients with adenocarcinoma of the low rectal cancer with the stage mrT2-3N0-1M0 who were treated from 2013 till 2018. All of these patients were given chemoradiation in the standard long-course fractionated radiation 2.0 Gy per day, total dose of 45 Gy and with Capecitabine in the daily dose of 825 mg / m2 in the days of radiation. If complete clinical and morphological regression of tumor was registered in 6 weeks after completion of CRT the patients were held 2 courses of consolidating chemotherapy with capecitabine in the daily dose of 3,500 mg / m2 for 14 days (the interval between chemotherapy courses was 7 days). Results. Complete tumor regression was recorded in 22 (31.4 ± 5.5%) of 70 patients. The median follow-up was 26 months: any signs of progression weren’t detected in 20 (90.9 ± 6.1%) patients with detailed survey which was held every 3 months, and local recurrence was detected (R0) in 2 (9.1 ± 6.1%) patients in the first year of follow-up. Conclusions. Neoadjuvant CLT and consolidating chemotherapy provide reliable local monitoring and prevention of hematogenous metastasis in patients with low rectal cancer. The preliminary results which were obtained in our research confirm the adequacy of the surviving approach after Complete tumor regression using the condition of active monitoring using a complex of clinical and instrumental methods. Final conclusions require further research.