Cancer Research and Treatment

Original Article

Comparison of Surveillance with Low-dose and Contrast-enhanced Chest Computed Tomography in Patients Disease-free for Two Years after Curative Resection for Lung Cancer: Bubse Na, Ji Hyeon Park, Kwon Joong Na, Samina Park, Chang Hyun Kang, Young Tae Kim, In Kyu Park; Received March 5, 2025 Accepted June 4, 2025 Published online June 5, 2025; DOI: https://doi.org/10.4143/crt.2025.256 [Accepted]

Abstract PDF: Purpose
Low-dose chest computed tomography (LDCT) is recommended for surveillance 2–3 years after curative resection of non-small cell lung cancer (NSCLC); however, supporting clinical evidence is limited. This study compared LDCT with contrast-enhanced chest computed tomography (CECT) in terms of recurrence detection and overall survival (OS) in patients two years after curative resection of NSCLC.
Materials and Methods
Among patients who underwent curative resection for NSCLC between January 2011 and December 2017 and survived for 2 years without recurrence, 2083 patients were included. Comparisons between the LDCT and CECT groups were performed in both the entire cohort and propensity score-matched cohort. The primary outcome was the difference in overall survival. Secondary outcomes included time-to-recurrence, recurrence-free survival, and post-recurrence survival in each group.
Results
In the propensity score-matched population, the 5-year OS (96.0% for LDCT, 98.0% for CECT, p=0.097) and recurrence-free survival (RFS) (95.4% for LDCT, 96.0% for CECT, p=0.76) did not differ. The OS and RFS did not differ in subgroup analyses stratified by pathologic stage and histologic type. In the competing risk analysis, the overall 5-year cumulative incidence of recurrence did not differ between the two groups. (4.56% for LDCT, 3.93% for CECT, p=0.765). When stratified by pathologic stage and histologic type, there was no significant difference in the cumulative incidence of recurrence. The distribution of recurrence sites did not differ between groups.
Conclusion
Similar OS and RFS were observed in LDCT and CECT surveillance in patients who achieved a 2-year disease-free status after curative resection for NSCLC.

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Review Article

Intensity-Modulated Radiation Therapy for Uterine Cervical Cancer to Reduce Toxicity and Enhance Efficacy – an Option or a Must?: A Narrative Review: Sea-Won Lee, Aeran Kim, Sung Jong Lee, Sung Hwan Kim, Jong Hoon Lee; Cancer Res Treat. 2024;56(1):1-17. Published online August 30, 2023; DOI: https://doi.org/10.4143/crt.2023.562

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Radiotherapy (RT) is a fundamental modality in treatment of cervical cancer. With advancement of technology, conventional RT used for external beam radiotherapy (EBRT) for over half a century has been rapidly replaced with intensity-modulated radiation therapy (IMRT) especially during the last decade. This newer technique is able to differentiate the intensity of radiation within the same field, thus reduces the inevitable exposure of radiation to normal organs and enables better dose delivery to tumors. Recently, the American Society for Radiation Oncology has released a guideline for RT in cervical cancer. Although a section of the guideline recommends IMRT for the purpose of toxicity reduction, a thorough review of the literature is necessary to understand the current status of IMRT in cervical cancer. This narrative review updates the recent high-level evidences regarding the efficacy and toxicity of IMRT and provides a better understanding of the most innovative techniques currently available for EBRT enabled by IMRT.

Citations

Citations to this article as recorded by

Can knowledge-based planning models validated on ethnically diverse patients lead to global standardisation of external beam radiation therapy for locally advanced cervix cancer?
Jeevanshu Jain, Monica Serban, Marianne Sanggaard Assenholt, Varsha Hande, Jamema Swamidas, Yvette Seppenwoolde, Joanne Alfieri, Kari Tanderup, Supriya Chopra
Radiotherapy and Oncology.2025; 204: 110694. CrossRef
Prediction of recurrence risk of cervical cancer after radiotherapy using multi-sequence MRI radiomics
Jie Chen, Lou Liu, Yi Fu, Lu Zhang, Shuyue Li, Juying Zhou, Chenying Ma
Radiation Medicine and Protection.2025; 6(3): 169. CrossRef
Analysis of risk factors for acute radiation toxicity in cervical cancer patients in FIGO IIIC1 and IIIC2 stages treated with definitive chemoradiation
Marija Živković Radojević, Jasmina Jovanović Mirković, Slađana Pirić, Christos Aleksopoulos, Neda Milosavljević
The European Physical Journal Special Topics.2025;[Epub] CrossRef
Comparative impact of supine vs prone positioning on dose distribution, acute toxicity, and setup error in postoperative radiotherapy for cervical cancer: a multidimensional propensity-matched cohort study
Nanjie Xiao, Cuiyun Yuan, Tianshu Zhao, Tie Xu, Jiaomei Zhou, Junfang Liao, Miao Peng, Chenbin Liu, Zhijian Chen, Jing Jin
Frontiers in Oncology.2025;[Epub] CrossRef
Long term clinical outcomes of cervical cancer patients who were recommended surgery but did not undergo it: A SEER database study
Zhaoming Zhang, Hongfu Zhao, Guanghui Cheng
European Journal of Surgical Oncology.2024; 50(10): 108572. CrossRef
Treatment of secondary uterine malignancy following radiotherapy for cervical cancer: a study based on the SEER database
Xiaojing Tong, Yunyun Xiao, Haozhen Li, Hang Zhang, Jiawen Li
BMC Women's Health.2024;[Epub] CrossRef

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Original Articles

Lung and Thoracic cancer

Predictive Value of Interstitial Lung Abnormalities for Postoperative Pulmonary Complications in Elderly Patients with Early-stage Lung Cancer: Won Gi Jeong, Yun-Hyeon Kim, Jong Eun Lee, In-Jae Oh, Sang Yun Song, Kum Ju Chae, Hye Mi Park; Cancer Res Treat. 2022;54(3):744-752. Published online September 28, 2021; DOI: https://doi.org/10.4143/crt.2021.772

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Purpose
Identifying pretreatment interstitial lung abnormalities (ILAs) is important because of their predictive value for complications after lung cancer treatment. This study aimed to assess the predictive value of ILAs for postoperative pulmonary complications (PPCs) in elderly patients undergoing curative resection for early-stage non-small cell lung cancer (NSCLC).
Materials and Methods
Elderly patients (age ≥ 70 years) who underwent curative resection for pathologic stage I or II NSCLC with normal preoperative spirometry results (pre-bronchodilator forced expiratory volume in 1 s to forced vital capacity [FVC] ratio > 0.70 and FVC ≥ 80% of the predicted value) between January 2012 and December 2019 were retrospectively identified. Univariable and multivariable regression analyses were performed to assess risk factors for PPCs. The Kaplan–Meier method and log-rank test were used to analyze the relationship between ILAs and postoperative mortality. One-way analysis of variance was performed to assess the correlation between ILAs and hospital stay duration.
Results
A total of 262 patients (median age, 73 [interquartile range, 71–76] years; 132 male) were evaluated. A multivariable logistic regression model revealed that, among several relevant risk factors, fibrotic ILAs independently predicted both overall PPCs (adjusted odds ratio [OR], 4.84; 95% confidence interval [CI], 1.35–17.38; p=0.016) and major PPCs (adjusted OR, 8.72; 95% CI, 1.71–44.38; p=0.009). Fibrotic ILAs were significantly associated with higher postoperative mortality and longer hospital stay (F=5.21, p=0.006).
Conclusion
Pretreatment fibrotic ILAs are associated with PPCs, higher postoperative mortality, and longer hospital stay.

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Ruiyuan Yang, Haoyu Wang, Dan Liu, Weimin Li
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Approach to the Evaluation and Management of Interstitial Lung Abnormalities: An Official American Thoracic Society Clinical Statement
Anna J. Podolanczuk, Gary M. Hunninghake, Kevin C. Wilson, Yet H. Khor, Fayez Kheir, Brandon Pang, Ayodeji Adegunsoye, Gretchen Cararie, Tamera J. Corte, Jim Flanagan, Gunnar Gudmundsson, Lida P. Hariri, Hiroto Hatabu, Stephen M. Humphries, Bhavika Kaul,
American Journal of Respiratory and Critical Care Medicine.2025; 211(7): 1132. CrossRef
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Pretreatment Interstitial Lung Abnormalities Detected on Abdominal Computed Tomography Scans in Prostate Cancer Patients
Hyun Jin Kim, Won Gi Jeong, Jeong Yeop Lee, Hyo-Jae Lee, Byung Chan Lee, Hyo Soon Lim, Yun-Hyeon Kim
Journal of Computer Assisted Tomography.2024; 48(3): 406. CrossRef
Interstitial Lung Abnormalities
Noriaki Wada, Gary M. Hunninghake, Hiroto Hatabu
Clinics in Chest Medicine.2024; 45(2): 433. CrossRef
Incidence and risk factors of pulmonary complications after lung cancer surgery: A systematic review and meta-analysis
Ting Deng, Jiamei Song, Jinmei Tuo, Yu Wang, Jin Li, Lorna Kwai Ping Suen, Yan Liang, Junliang Ma, Shaolin Chen
Heliyon.2024; 10(12): e32821. CrossRef
Survival impact of fibrotic interstitial lung abnormalities in resected stage IA non-small cell lung cancer
Won Gi Jeong, Yun-Hyeon Kim
The British Journal of Radiology.2023;[Epub] CrossRef
Radiologic Progression of Interstitial Lung Abnormalities following Surgical Resection in Patients with Lung Cancer
Yoon Joo Shin, Jeong Geun Yi, Mi Young Kim, Donghee Son, Su Yeon Ahn
Journal of Clinical Medicine.2023; 12(21): 6858. CrossRef
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Pengfei Wang, Li Zhang, Qian Guo, Lifen Zhao, Yanyan Hao
Open Medicine.2023;[Epub] CrossRef
Clinical implication of interstitial lung abnormality in elderly patients with early‐stage non‐small cell lung cancer
Seong Woo Cho, Won Gi Jeong, Jong Eun Lee, In‐Jae Oh, Sang Yun Song, Hye Mi Park, Hyo‐Jae Lee, Yun‐Hyeon Kim
Thoracic Cancer.2022; 13(7): 977. CrossRef

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Breast cancer

Effect of Postoperative Radiotherapy after Primary Tumor Resection in De Novo Stage IV Breast Cancer: A Multicenter Retrospective Study (KROG 19-02): Yeon Joo Kim, Yeon-Joo Kim, Yong Bae Kim, Ik Jae Lee, Jeanny Kwon, Kyubo Kim, Jihye Cha, Myungsoo Kim, In Young Jo, Jung Hoon Kim, Jaehyeon Park, Jin Hee Kim, Juree Kim, Kyung Hwan Shin, Su Ssan Kim; Cancer Res Treat. 2022;54(2):478-487. Published online July 12, 2021; DOI: https://doi.org/10.4143/crt.2021.632

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Purpose
This study aimed to investigate the impact of postoperative radiotherapy (PORT) in de novo metastatic breast cancer (dnMBC) patients undergoing planned primary tumor resection (PTR) and to identify the subgroup of patients who would most benefit from PORT.
Materials and Methods
This study enrolled 426 patients with dnMBC administered PTR alone or with PORT. The primary and secondary outcomes were overall and progression-free survival (OS and PFS), respectively.
Results
The median follow-up time was 53.7 months (range, 3.1 to 194.4). The 5-year OS and PFS rates were 73.2% and 32.0%, respectively. For OS, clinical T3/4 category, triple-negative breast cancer (TNBC), postoperative chemotherapy alone were significantly poor prognostic factors, and administration of PORT failed to show its significance. Regarding PFS, PORT was a favorable prognostic factor (hazard ratio, 0.64; 95% confidence interval, 0.50 to 0.82; p < 0.001), in addition to T1/2 category, ≤ 5 metastases, and non-TNBC. According to the multivariate analyses of OS in the PORT group, we divided the patients into three groups (group 1, T1/2 and non-TNBC [n=193]; group 2, T3/4 and non-TNBC [n=171]; and group 3, TNBC [n=49]), and evaluated the effect of PORT. Although PORT had no significance for OS in all subgroups, it was a significant factor for good prognosis regarding PFS in groups 1 and 2, not in group 3.
Conclusion
PORT was associated with a significantly better PFS in patients with dnMBC who underwent PTR. Patients with clinical T1/2 category and non-TNBC benefited most from PORT, while those with TNBC showed little benefit.

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Impact of high dose radiotherapy for breast tumor in locoregionally uncontrolled stage IV breast cancer: a need for a risk-stratified approach
Nalee Kim, Haeyoung Kim, Won Park, Won Kyung Cho, Tae Gyu Kim, Young-Hyuck Im, Jin Seok Ahn, Yeon Hee Park, Ji-Yeon Kim
Radiation Oncology.2023;[Epub] CrossRef
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Chaofan Li, Mengjie Liu, Jia Li, Weiwei Wang, Cong Feng, Yifan Cai, Fei Wu, Xixi Zhao, Chong Du, Yinbin Zhang, Yusheng Wang, Shuqun Zhang, Jingkun Qu
Frontiers in Public Health.2022;[Epub] CrossRef
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SSRN Electronic Journal .2022;[Epub] CrossRef

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CNS cancer

The Role of Postoperative Radiotherapy in Intracranial Solitary Fibrous Tumor/Hemangiopericytoma: A Multi-institutional Retrospective Study (KROG 18-11): Joo Ho Lee, Seung Hyuck Jeon, Chul-Kee Park, Sung-Hye Park, Hong In Yoon, Jong Hee Chang, Chang-Ok Suh, Su Jeong Kang, Do Hoon Lim, In Ah Kim, Jin Hee Kim, Jung Ho Im, Sung-Hwan Kim, Chan Woo Wee, Il Han Kim; Cancer Res Treat. 2022;54(1):65-74. Published online March 24, 2021; DOI: https://doi.org/10.4143/crt.2021.142

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to evaluate the role of postoperative radiotherapy (PORT) in intracranial solitary fibrous tumor/hemangiopericytoma (SFT/HPC).
Materials and Methods
A total of 133 patients with histologically confirmed HPC were included from eight institutions. Gross total resection (GTR) and subtotal resection (STR) were performed in 86 and 47 patients, respectively. PORT was performed in 85 patients (64%). The prognostic effects of sex, age, performance, World Health Organization (WHO) grade, location, size, Ki-67, surgical extent, and PORT on local control (LC), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) were estimated by univariate and multivariate analyses.
Results
The 10-year PFS, and OS rates were 45%, and 71%, respectively. The multivariate analysis suggested that PORT significantly improved LC (p < 0.001) and PFS (p < 0.001). The PFS benefit of PORT was maintained in the subgroup of GTR (p=0.001), WHO grade II (p=0.001), or STR (p < 0.001). In the favorable subgroup of GTR and WHO grade II, PORT was also significantly related to better PFS (p=0.028). WHO grade III was significantly associated with poor DMFS (p=0.029). In the PORT subgroup, the 0-0.5 cm margin of the target volume showed an inferior LC to a large margin with 1.0-2.0 cm (p=0.021). Time-dependent Cox proportion analysis showed that distant failures were significantly associated with poor OS (p=0.003).
Conclusion
This multicenter study supports the role of PORT in disease control of intracranial SFT/HPC, irrespective of the surgical extent and grade. For LC, PORT should enclose the tumor bed with sufficient margin.

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Patterns of Failure after Postoperative Radiation Therapy for Endometrial Carcinoma: Suzy Kim, Hong-Gyun Wu, Hyo-Pyo Lee, Soon-Beom Kang, Yong-Sang Song, Noh-Hyun Park, Sung Whan Ha; Cancer Res Treat. 2006;38(3):133-138. Published online June 30, 2006; DOI: https://doi.org/10.4143/crt.2006.38.3.133

Abstract PDF PubReader ePub

Purpose

We tried to investigate the outcome and patterns of failure of endometrial cancer patients who were treated with surgery and postoperative radiation therapy (RT).

Materials and Methods

Eighty-three patients with endometrial cancer who received postoperative RT between May 1979 and August 2000 were included in this retrospective study. Forty-one patients received total abdominal hysterectomy, 41 patients received Wertheim's operation and 1 underwent vaginal hysterectomy. Pelvic lymph node dissection or pelvic lymph node sampling was done in 56 patients and peritoneal cytology was done in 35. All the patients were staged according to 1988 FIGO (International Federation of Gynecology and Obstetrics) staging system; 2 were stage IA, 23 were stage IB, 20 were stage IC, 4 were stage IIA, 5 were stage IIB, 9 were stage IIIA, 2 were stage IIIB and 18 were stage IIIC. The histologic diagnoses were adenocarcinoma in seventy-four patients (89%). The histologic grades were Grade 1, 2 and 3 in 21 (25%), 43 (52%) and 10 (12%) patients, respectively. All the patients received external beam RT (EBRT) with a median dose of 5,040 cGy (range: 4,500~5,075 cGy) to the whole pelvis. Five patients with pathologically confirmed paraaortic lymph node metastasis received 4500 cGy to the paraaortic lymph nodes. Fifteen patients received low-dose intracavitary brachytherapy after their EBRT. A total dose of 7,500~9,540 cGy (median dose: 8511) was prescribed to the vaginal surface.

Results

Overall, 11 patients (13%) experienced disease relapse: 4 with initial stage I or II disease and 7 with initial stage III disease. Among the 54 stage I or II patients, 1 (2%) relapsed in the pelvis only, 2 (4%) relapsed in the vagina and distant organs, and 1 (2%) relapsed in the paraaortic lymph nodes (PANs). Among the 29 stage III patients, 1 (3%) relapsed in the vagina. The most common sites of failure for the stage III patients were the peritoneum (3 patients, 10%), PANs (2 patients, 7%), and lung (2 patients, 7%). With a median follow-up period of 86 months, the overall survival (OS) and disease-free survival (DFS) rates at 5 years were 87% for both. The five-year DFS rate was 93%, 100% and 74% for the stage I, II and III patients, respectively. Three patients experienced severe radiation-related late complications: RTOG (Radiation Therapy Oncology Group) grade 3 radiation cystitis was seen in one patient, and grade 3 bowel obstruction was seen in two patients.

Conclusions

Postoperative RT was useful for controlling pelvic disease. The major patterns of failure for stage III patients were peritoneal seeding and distant metastasis. Selective use of whole abdominal radiotherapy or adjuvant chemotherapy may improve the therapeutic outcome of these patients.

Citations

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Pattern of care and clinical outcome of patients with carcinoma endometrium and the impact of central histopathological review on management: A tertiary cancer centre experience
Rakhi Verma, Ajeet K. Gandhi, Madhup Rastogi, Vachaspati K. Mishra, Vikas Sharma, Akash Agarwal, Saumya Shukla, Rohini Khurana, Rahat Hadi, Anoop K. Srivastava, Nuzhat Husain
Journal of Cancer Research and Therapeutics.2024; 20(5): 1557. CrossRef
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Jennifer Yoon, Halle Fitzgerald, Yaqun Wang, Qingyang Wang, Irina Vergalasova, Mohamed A. Elshaikh, Irina Dimitrova, Shari Damast, Jessie Y. Li, Emma C. Fields, Sushil Beriwal, Andrew Keller, Elizabeth A. Kidd, Melissa Usoz, Shruti Jolly, Elizabeth Jawors
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Efficacy of Para-Aortic Lymphadenectomy in Early-Stage Endometrioid Uterine Corpus Cancer
Seo-Yun Tong, Jong-Min Lee, Jae-Kwan Lee, Jae Weon Kim, Chi-Heum Cho, Seok-Mo Kim, Sang-Yoon Park, Chan-Yong Park, Ki-Tae Kim
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Nan-Hee Jeong, Jong-Min Lee, Seon-Kyung Lee
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Treatment Results of Postoperative Radiation Therapy for Malignant and Atypical Meningioma: Sang Min Yoon, Seung Do Ahn, Hyesook Chang, Eun Kyung Choi, Jong Hun Kim, Sang wook Lee, Chang Jin Kim, Jung Hun Kim, Byung Deuk Kwon; Cancer Res Treat. 2002;34(2):139-144. Published online April 30, 2002; DOI: https://doi.org/10.4143/crt.2002.34.2.139

Abstract PDF

PURPOSE
We evaluated the survival rate, prognostic factors and patterns of failure in malignant and atypical meningiomas, and investigated the role of radiation therapy in the treatment of these tumors.
MATERIALS AND METHODS
We retrospectively reviewed nineteen patients treated at Asan Medical Center between Mar. 1994 and Jun. 2000 with histologically confirmed malignant or atypical meningiomas. The median patient age was 52 years. The extent of surgery prior to radiation was gross total resection in 13 and subtotal resection in 6. Eleven patients were referred for radiation immediately after diagnosis and the remainder after at least one recurrence. All patients received megavoltage radiation to a median dose of 55.8 Gy. The median follow-up period was 41 months.
RESULTS
Eleven patients (57.9%) showed no evidence of disease, five patients died of meningioma and three were alive with disease. The 5-year overall and relapse-free survivals were 75.9 and 50.6%, respectively. There were no statistically significant prognostic factors found to be associated with relapse-free survival by univariate or multivariate analysis. During the follow-up period, no significant treatment-related complications were detected.
CONCLUSION
The major patterns of failure were in-field recurrence. In order to reduce local failure, a higher radiation dose may be needed and a high precision therapy should be considered.

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Revisiting Adjuvant Radiotherapy After Gross Total Resection of World Health Organization Grade II Meningioma
Christopher S. Graffeo, Heather E. Leeper, Avital Perry, Joon H. Uhm, Daniel J. Lachance, Paul D. Brown, Daniel J. Ma, Jamie J. Van Gompel, Caterina Giannini, Derek R. Johnson, Aditya Raghunathan
World Neurosurgery.2017; 103: 655. CrossRef

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Results of Postoperative Radiation Therapy in 77 Patients of Breast Cancer: Yeon Shil Kim, Hong Seok Jang, Mi Ryeong Ryu, Sung Hwan Kim, Sang Sul Chung, Sei Chul Yoon, In Chul Kim, Kyung Sub Shinn; J Korean Cancer Assoc. 1997;29(6):1049-1060.

Abstract PDF: PURPOSE
This retrospective study was performed to evaluate the effect of postoperative adjuvant radiation therapy of breast cancer on survival, failure patterns and to identify unfavorable prognostic factors.
MATERIALS AND METHODS
Seventy-seven patients were analysed retrospectively. Median follow up period was 72 months. According to AJCC system, fifty-eight patients (75%) were advanced than Stage IIb. Among 77 patients, 66 patients (86%) received mastectomy and axillary LN dissection and the other 11 patients (14%) received partial mastectomy and axillary LN dissection. Postoperative radiation therapy with 6 MV X-ray was given to the chest wall and regional lymphatics with total dose of 50 to 55 Gy. Fifty-five patients (71%) received CMF or CAF chemotherapy prior to or after radiation therapy.
RESULTS
The 5 year and 10 year survival rate were 64.4% and 51.3%, respectively and 5 year and 10 year disease free survival rate were 57.6% and 47.5%, respectively. Median survival duration was 91 months. Of the 77 patients, 59 patients were evaluable for pattern of failure. Of these, eighteen patients (31%) failed. Initial failure pattern was as follow: 7 (12%) at locoregional, 3 (5%) in distant metastasis, 8 (14%) with locoregional and distant metastasis. But the pattern of final failure at the time of last follow up was contrasted. Distanf failure was the predominant pattern of failure with 29% of patients. Overall survival and disease free survival was significantly influenced by 6 factors with univariated analysis (p<0.05): AJC Stage, T stage, N Stage, number of involved axilliary LN, SCL LN mets, failure pattern. By multivariate analysis the survival difference continued to be significant in 3 factors : T stage, number of involved axillary LN, failure pattern.
CONCLUSION
These data demonstrate high locoregional control and survival rate using the combination of surgery and radiotherapy for the patients with locally advanced breast cancer. But predominant failure pattern was distant dissemination. Therefore more effective systemic therapy is needed to improve overall survival.

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The Results of Postoperative Radiation Therapy in the Rectal Cancer: Mi Ryeong Ryu, Hong Seok Jang, Sei Chul Yoon, Su Mi Chung, Yeon Shil Kim, Se Kyung Kim, In Chul Kim, Kyung Sub Shinn; J Korean Cancer Assoc. 1997;29(1):111-116.

Abstract PDF: PURPOSE
This study was designed to evaluate the prognostic factors, survival rate and local recurrence rate of the patients with rectal cancer who received postoperative radiation therapy.
METHODS
& MATERIALS: Seventy patients with rectal cancer received postoperative radiation therapy after curative surgery at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medial College between May 1984 and April 1993. Of the seventy patients, sixty-four evaluable patients were analysed retrospectively. There were 34 men and 28 women. Age at diagnosis ranged from 23 to 74 years. The distribution of stage according to the modified Astler-Coller (MAC) system was as follow: 12 in B2+3, 2 in C1, and 50 in C2+3. Postoperative adjuvant therapy included pelvic radiotherapy in all cases and chemotherapy in addition in 55 cases. A total dose of 45 to 60 Gy (median dose: 55.8Gy) was delivered in a period of 5 to 6 weeks and the follow-up period ranged from 26 to 133 months with a median of 55 months.
RESULTS
Overall two-year and five-year actuarial survival rate were 70.3% and 51.4%, 90.9% and 90.9% in stage B2+3, and 68.2% and 53.6% in stage C. Local failure occurred in 13 (20.3%) of the 64 patients and distant failure rate was 18.8% (12/64). Severe late complication was small bowel obstruction in 4 patients and surgery was required in 3 patients (5%). The significant prognostic factors were stage (p=0.0019) and histologic differentiation (p=0.0046).
CONCLUSION
This study suggested a potential adjuvant role for radiation. However, the possible reduction in local failure rates in this study compared with historic control groups must be verified in randomized trial.

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