[Chemotherapy in advanced rectal cancers].
ABSTRACT The aim of this retrospective study was to specify the therapeutic strategy in the management of locally advanced rectal cancers in our practice in front of lack of radiotherapy.
This study had concerned 52 patients suffering from locally advanced rectal cancers, with mean age of 44 years old (range: 22-68). Evaluation for down staging was based on clinical, CT scan and intraoperative features. Patients were classified as T4NXM0. Thirty one patients (57,7%) had left iliac colostomy associated with a neoadjuvant chemotherapy, 12 had a left iliac palliative colostomy and 9 had chemotherapy only.
Thirty two patients (80%) suffered from digestive toxicity due to chemotherapy, 11 patients had hematologic toxicity and 4 other had skin and mucous toxicity. Between the thirty one patients who had colostomy and chemotherapy, 4 (12,9%) responded well and underwent to curative rectal resection, in the remaining patients, the colostomy stayed palliative. The median survey time was 9,5 months.
Our poor results confirmed the need of early detection and radiotherapy in the management of our patients.