Therapeutic pathomorphosis of polyradiomodification programs in the combined treatment of resectable rectal cancer and its effect on long-term results

The article presents data, which shows that the actual efficiency of polyradiomodification programs is determined by the frequency of achieving therapeutic pathomorphism of grade III-IV. The high frequency of grade III-IV therapeutic pathomorphosis was achieved with the use of polyradiomodification programs with 14-day Capecitabine (Cap) intake. The best results in achieving III-IV degrees of therapeutic pathomorphosis, ensuring full local control and a reliable reduction in the incidence of distant metastases were obtained with the use of polyradiomodification programs with Cap14 (Cap 14 + Metronidazole and Cap 14 + Metronidazole + ultra high frequency hyperthermia) and surgery delay for 4-6 weeks after completion of preoperative treatment. With the use of polyradiomodification, a pronounced local control was achieved, however, given a small number of cancer relapses, it was not possible to establish its dependence on the degree of therapeutic pathomorphosis. The best control was achieved at stage T2N0M0 (no distant metastases were detected) and at stage T2-3N1-2M0 with a decrease in the incidence of distant metastases 2.3 times, compared with the frequency of metastases with the use of polyradiomodification programs with Cap5 (p = 0.0279).