Role of neo-adjuvant chemo - radiotherapy in colorectal malignancy

Background: Adenocarcinoma of the colon and rectum is one among most common site of new cancer cases and deaths in both men (following prostate and lung/bronchus) and women (following breast, cervix and lung/bronchus). The objective of this study was to evaluate the usefulness of neoadjuvant chemo-radiotherapy in colorectal carcinoma. Methods: This study has been conducted in the department of surgery, Govt. Rajaji hospital, Madurai during 2008-2009. 20 patients were subjected to detailed history, thorough clinical examination of the abdomen, digital rectal examination, proctoscopy, and scopy guided biopsy was taken for histopathological examination. Results: All patients were subjected to chemo-radiotherapy for 6weeks, followed by surgery. 20% of the patients underwent low anterior resection, 35% of patients underwent anterior resection, 35% of the patients underwent abdomino-perineal resection, 10% had undergone loop colostomy. Out of the 20 patients 2 female patients had posterior vaginal wall fixity which following CRT underwent APR without resection of the posterior vaginal wall. Conclusions: Neoadjuvant therapy may be considered a rational approach for treatment of curative rectal cancer. Volumetric reduction of neoplasia, mesorectum and lateral pelvic nodes was evident in 90% of the patients.