Prognotic Analysis of Recurrent Rectal Cancer by Treatment of Combining 3DCRT and XELOX

Objective To explore the factors related the prognosis of recurrent rectal cancer （CRC）by the treatment of 3-dimensional conformal radiotherapy(3DCRT) and capecitabine and oxaliplatin (XELOX) chemotherapy and to compare the efficiency of concurrent chemoradiotherapy with sequent chemoradiotherapy in recurrent rectal cancer. Methods Eighty-three cases with recurrent CRC were selected in the study and clinical/pathological factors were collected and patients were follow-up. Kaplan-Meier method was used to calculate survival rate. Log-rank test and proportional-hazards regression model （Cox model） were used for univariate and multivariate analysis of prognosis. Thirty-nine cases were given concurrent chemoradiotherapy and 44 cases were given sequent chemoradiotherapy. Results Single factor analysis indicated that tumor therapeutic measure, diameter of tumor, the location of recurrent CRC，type of histology were significantly influential factors of the prognosis. One, two and three-year survival rates of concurrent chemoradiotherapy and sequent chemoradiotherapy were 89.3%,68.5%,47.2% and 83.3%,56.0%,27.4%, respectively. Tumor therapeutic measure, diameter of tumor, type of histology were independent prognostic factors of recurrent CRC. The overall response rate(CR+PR) in concurrent and sequent 3DCRT and XELOX chemoradiotherapy were 66.7% and 43.2%, respectively （P<0．05）. Disease control rate (CR+PR+SD) were 92.3% and 73.5%(P<0.05）,respectively. There were similar side effects in the concurrent and sequent 3DCRT and XELOX chemoradiotherapy group. Conclusion 3DCRT with concurrent XELOX chemotherapy can be considered as an effective and feasible approach to recurrent CRC patients and the concurrent chemoradiotherapy may improve efficiency sensitization, and complement each other.