Efficacy of chemoradiotherapy on pain relief in patients with intrapelvic recurrence of rectal cancer

Purpose: To assess the efficacy of chemoradiotherapy on pain relief in patients with intrapelvic recurrence of rectal cancer. Methods: The records of 30 patients treated with radiotherapy with or without chemotherapy for intrapelvic recurrence of rectal cancer between September 1993 and February 1999 were retrospectively reviewed. There were 17 patients in the chemoradiotherapy (CRT) group and 13 patients in the radiotherapy alone (RTA) group. Simultaneous extrapelvic distant metastases were found in 11 patients in the CRT group and in seven patients in the RTA group. Radiotherapy was administered with a median total dose of 50 Gy in both groups. In the CRT group, 15 patients received 5-fluorouracil by continuous infusion and two patients received irinotecan in a biweekly infusion schedule during the course of radiotherapy. The response rate and duration of pain relief were evaluated and were compared between the two groups. Results: The response rate of pain relief in the CRT and RTA was 100 and 77%, respectively. The median duration of pain relief in the CRT and RTA groups was 7.8 and 4.0 months, respectively and there was a significant difference between the two groups (P = 0.019). The median survival time from the start of radiotherapy was 15.1 and 9.3 months in the CRT and RTA groups, respectively, and there was a significant difference between the two groups (P 0.046). Conclusions: The results suggest that chemoradiotherapy for intrapelvic recurrence of rectal cancer for the purpose of pain relief appears to be more effective than radiotherapy alone.