Endoscopice Evaluation of Rediation Effect for Preoperative Irradiation Therapy in Rectal Cancer -Comparison of Histologic and Endoscopic Findings of Radiation Effect-

Nobuhiro Takiguchi, Hiromi Sarashina, Norio Saito, Masao Nunomura, Ikuo Inoue, Hajime Nakayama, Naoki Saegusa, Toshio Omori, Keiji Koda, Takahisa Sano, Masahiko Shimoyama, Kimio Saito, Tadashi Toyosawa, Shinji Yanagisawa, Nobuyuki Nakajima

First Department of Surgery, School of Medicine, Chiba University

Thirty four patients with advanced rectal cancer treated by preoperative irradiation were examined endoscopically and histologically. On the bases of the histologic findings all the cases were classified into noneffective group (16 cases) and effective group (18 cases). We tried to establish criteria for endoscopic evaluation of radiation effect composed of the following 5 items; 1) flattening of the marginal wall, 2) smoothing of the crater, 3) removal of the dirty coat of the ulcer bottom, 4) improvement in ease of bleeding, 5) improvement of stenosis. According to each criterion, the radiation effect was evaluated as marked (2 points), moderate (1 point), and little (0 point) change. The total score of each point was defined as endoscopic evaluation. Endoscopic evaluation was 5.4+1.8 in non-effective group and 8.1±1.6 in effective group (p<0.01). So the endoscopic evaluation was found to be correlated with the histologic evaluation. It was thought that the endoscopically revealed changes in the tumor shape could make us assume the histological radiation effect.

Key words
preoperative irradiation therapy for rectal cancer, endoscopic observation, radiation effect, mucinous degeneration

Reprint requests
Nobuhiro Takiguchi First Department of Surgery, Chiba University school of Medicine
1-8-1 Inohana, Chuoh-ku, Chiba, 280 JAPAN

Accepted
May 13, 1992

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