[A case report of effective chemoradiation with 5'-DFUR and concomitant preoperative radiotherapy of the lower rectum].

We treated a lower rectal carcinoma patient with preoperative radiation and chemotherapy, resulting in a downstaging, and the findings are reported herein. The patient is a 55-year-old woman endoscopically diagnosed with advanced rectal carcinoma at a site 3 cm from the dental line. Preoperative radiation and chemotherapy included whole pelvis irradiation (44 Gy in total) and 800 mg/day of 5'-DFUR administered until one day before the operation. On the 20th day after completing irradiation, a low anterior resection of the rectum was conducted. During the operation, we found serositis of the small intestine and retroperitoneal fibrosis thought to be due to the irradiation. Histopathologic findings showed: invasion degree, sm2; stage I with N0; and histologic grading, Grade 2. The patient started drinking water from postoperative day 1, and was discharged on postoperative day 11. At present, in Europe and the USA, large scale studies are being conducted to evaluate preoperative radiation and chemotherapy in patients with lower rectal carcinoma. We think that this therapy is an effective treatment, since a distance (AW) from the lower margin of the tumor and the cut edge of the anal end can be established.