Abstract:

Between January 1989- December 1994, postoperative radiotherapy was given 116 patients with stage B2, B3, Cl, C2, C3, rectum carcinoma, according to modified Astler Coller staging system. Age of patients ranged from 18 to 82 (median 51.5 );73 (2.9%) were men, 43 (37.1%) were women; 54 (46.6%)of patients were staged as B2-3 and 62 (53.4%)as C1-3 Fifty-one (44%) patients underwent abdominoperineal resection, 36 patients (31%) low anterior resection, and 29 patients (25%) anterior resection. Radiotherapy was given by (Co 60 teletherapy or lineer-accelerator (6- 25MV) on prone position to a total dose of 50,4-54 Gy (median 54 Gy) with 1,8 Gy daily fractions. During radiotherapy, 5 patients (4.3%) developed diarrhea grade 2, which caused an interruption of 3-10 days. Late complications such as bowel obstruction or necrosis were seen in 10(8.6%) patients. Eighteen patients (15.3%) had developed local recurrence and 22 (19.9%) patitents had distant metastasis; the time to local recurrence vvas 11-48 months (median 20.5 months). The five-year local, distant matastasis free survival, disease free survival and overall survival rates were 81.0%, 73.0%, 60.6% and 72.5% respectively. The local control rates were influenced by the tumour-anal verge distance (p=0.049) and the surgical methods (p=0.007), the disease free survival rates by the tumour-anal verge distance (p=0.035), the surgical methods(p=0.35), the stage (p=0.048) and the histopathological diagnosis (p=0.017), wich were evaluated by univariant analysis. Multivariate analysis of Cox regression model did not reveal any independent prognostic factor. It was obtained, that the histopathology (p=0.052)was the independent prognostic factor for disease free survival, the stage (p=0.025) and histopathology (p=0.014) for distant metastasis free survival, and the sex (p=0.042) for the overall survival.

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