ORGAN SAVING TREATMENT OF RECTAL CANCER

Objective: to evaluate the results of “watch and wait” approach for rectal cancer patients with complete clinical response after neoadjuvant chemoradiotherapy (CRT) followed by consolidation chemotherapy.

Materials and methods. Between 2013 and 2016, 130 patients who were diagnosed with stage T2N0–1M0–T3(CRM+)–4N0–2M0 middle and low rectal cancer were treated by CRT (single dose 2 Gy to a total dose 50–54 Gy with concominant capecitabine 850 mg/m2 /day of radiotherapy) with consolidation chemotherapy (CapOx) (capecitabine 2000 mg/m2 14 days and oxaliplatin 130 mg/m2 intravenous once in 3 weeks).

Results. 21 patient showed complete clinical response. During the time of observation (median 14.6 month) all patients alive without signs of recurrence and progression.

Conclusion. Preliminary results showed that organ saving treatment for rectal cancer patients with a complete clinical response is oncologically safe when followed by strict selection criteria and active follow-up, including endoscopy and magnetic resonance imagin. Future investigation is needed to justify this statement. Probability of complete response is higher for early stages of rectal cancer. 

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