Concurrent Chemoradiotherapy for Squamous Cell Carcinoma of the Rectum

Background/Aims: Primary squamous cell carcinoma of the rectum is a rare malignancy. Early reports suggest that the standard treatment is surgery, but clinical outcomes of chemoradiotherapy are more satisfying than those of surgery in recent experience. Our aim was to ascertain the effectiveness of chemoradiotherapy for squamous cell carcinoma of the rectum. Methodology: Between May 2002 and April 2006, four patients with primary squamous cell carcinoma of the rectum underwent curative concurrent chemoradiotherapy. The clinical stage of the patients was T3N1M0 in one patient, T1N2M0 in two, and T2N0M0 in one. Radiotherapy was administered to the entire pelvis, followed by a boost to the primary tumor. The total dose ranged from 5040cGy to 6300cGy in 180cGy fractions. Curative chemotherapy was concurrently initiated on the first day of pelvic radiotherapy, and a capecitabine plus cisplatin or 5-fluorouracil plus cisplatin regimen was used. Results: A complete clinical response was achieved in all four patients. One patient died of pneumonia 2 months after chemoradiotherapy without progression of the primary tumor. The remaining three patients have been alive with no evidence of disease for 52-99 months. Conclusions: The results suggest that chemoradiotherapy is an effective treatment option for squamous cell carcinoma of the rectum.