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Annals of Surgical Oncology 9:292-297 (2002)
© 2002 Society of Surgical Oncology

ORIGINAL ARTICLES

An Experimental Evaluation of Three Preoperative Radiation Regimens for Resectable Rectal Cancer

Genc Basha, MD, PhD, Willy Landuyt, SrSc, Jack Fowler, PhD, Dirk Vordermark, MD, PhD, Karin Haustermans, MD, PhD, Karel Geboes, MD, PhD, Walter Van den Bogaert, MD, PhD, Sing Hiem Yap, MD, PhD, Philippe Lambin, MD, PhD and Freddy Penninckx, MD, PhD

From the Departments of Abdominal Surgery (GB, FP), Radiobiology/Radiotherapy (WL, JF, KH, WVdB, PL), Pathology (KG), and Hepatology (SHY), University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Belgium; and Department of Experimental Therapy (DV), The Netherlands Cancer Institute, Amsterdam, The Netherlands.

Correspondence: Address correspondence and reprint requests to: Freddy Penninckx, MD, PhD, Department of Abdominal Surgery, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium; Fax: 32-1-634-4832; E-mail: freddy.penninckx{at}uz.kuleuven.ac.be

Background: We investigated the degree of tumor cell killing after radiotherapy regimens commonly used in clinical practice in comparison with an accelerated schedule.

Methods: Mtln3 mammary adenocarcinoma tumor cells were inoculated subcutaneously in the hind leg of syngeneic Fischer 344 rats. Tumors were irradiated with 5 x 5 Gy in 5 days, 10 x 3 Gy over 10 days, or 5 x (2 x 3) Gy in 5 days. After excision of the irradiated tumors, the dye exclusion, a tetrazolium-based colorimetric and the clonogenic assays were used to determine tumor cell viability and surviving fractions.

Results: Estimated potential doubling time values indicate a rapid proliferation capacity, comparable with potential doubling time values in human rectal cancer. The dye exclusion and clonogenic assays revealed a significantly higher degree of cell killing after the hypofractionated and the accelerated regimens of, respectively, 5 x 5 Gy and 5 x (2 x 3) Gy over 5 days compared with 10 x 3 Gy over 10 days.

Conclusions: A shorter treatment time offered the best therapeutic efficacy. The schedule involving two daily fractions of 3 Gy over 5 days should be less toxic than 5 x 5 Gy and may therefore provide a therapeutic advantage.

Key Words: Rectal carcinoma • Preoperative irradiation • Total treatment time • Fractionation • Tumor cell proliferation






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