DIFFERENTIATED APPROACH TO PROLONGED NEOADJUVANT CHEMORADIATION THERAPY IN COMPLEX TREATMENT OF RECTAL CANCER
The study included 60 patients with resectable rectal cancer who underwent a course of prolonged preoperative chemoradiotherapy. DNA cytometry with the proliferation index assessment was performed before, during and after treatment. The results of DNA cytometric tests were used to divide all patients into 2 groups according to the reduction in proliferation levels. In patients with the indicator of 1.5 times and more, the radiation treatment was considered effective and continued to a total focal dose of 50-54 Gr. The biopsy material of the above patients was studied again 4 weeks after the completion of the full course of prolonged radiation therapy in order to determine the optimal time for surgical treatment. Patients with a decrease in the tumor proliferation index of less than 1.5 times stopped receiving radiotherapy. The overall survival rate differed between the studied groups. The differentiated approach to complex treatment of rectal cancer was clinically effective, in particular, the dynamic evaluation of chemoradiotherapy by comparative DNA cytometry of the biopsy material.