Postradiation Regression of Locally Advanced Rectal Cancer: Two Clinical Cases

Abstract

In the Russian Federation, the incidence of malignant neoplasms is more than 50 thousand new cases per year. Since 1990 the combined treatment method is the standard in the treatment of patients with locally advanced rectal cancer. During the evolution of this method, preoperative radiation / chemo-radiation therapy has taken a strong position in the standards for treatment of rectal cancer. Currently, preoperative remote radiation therapy at a dose of 45-52Gy is included in treatment standards for rectal cancer. The main objective of neoadjuvant treatment is to achieve tumor regression. When a complete regression of the tumor is achieved, the task of choosing tactics arises - to carry out surgical treatment, or to apply expectant tactics. In the first clinical case, the patient underwent preoperative chemoradiation treatment with 40.8 Gy combined with capecitabine, after which 4 courses of consolidating chemotherapy were carried out followed by surgery. In the second case, the patient underwent neoadjuvant chemoradiation therapy with 52.5 Gy combined with capecitabine. Given the pronounced positive dynamics, 4 courses of consolidating chemotherapy were performed. After the control study, a complete tumor response to the therapy was revealed. Considering the MRI data and the pronounced positive dynamics, the decision of the multidisciplinary team was the tactics of dynamic observation of the patient.