6533b857fe1ef96bd12b3a92
RESEARCH PRODUCT
Sequential boost in neoadjuvant irradiation for T3N0-1 rectal cancer: long-term results from a single-center experience.
Rosario MazzolaTeresa CucchiaraNunzia ScibettaRoberto LagallaVanessa FigliaF. SciumèGioacchino Di PaolaM. GueciGiuseppe FerreraFilippo AlongiMaria Pia PappalardoAntonio Lo Castosubject
MaleCancer ResearchTime FactorsTumor downsizingColorectal cancermedicine.medical_treatmentAnal CanalKaplan-Meier EstimateSingle Center030218 nuclear medicine & medical imaging0302 clinical medicineAdjuvantNeoadjuvant therapyDigestive System Surgical ProceduresTumor Regression GradeIleostomyMedicine (all)Colorectal cancer; Radiation therapy; Tumor downsizing; Adenocarcinoma; Adult; Aged; Anal Canal; Antineoplastic Agents; Capecitabine; Chemoradiotherapy; Digestive System Surgical Procedures; Female; Fluorouracil; Follow-Up Studies; Gastrointestinal Tract; Humans; Ileostomy; Kaplan-Meier Estimate; Male; Middle Aged; Neoadjuvant Therapy; Neoplasm Staging; Organ Sparing Treatments; Radiotherapy Dosage; Radiotherapy Adjuvant; Rectal Neoplasms; Retrospective Studies; Time Factors; Treatment Outcome; Urogenital System; Medicine (all); Oncology; Cancer ResearchRadiotherapy DosageGeneral MedicineChemoradiotherapyMiddle AgedNeoadjuvant TherapyRadiation therapyTreatment OutcomeOncology030220 oncology & carcinogenesisFemaleRadiologyFluorouracilmedicine.drugAdultmedicine.medical_specialtyUrogenital SystemAntineoplastic AgentsAdenocarcinomaCapecitabine03 medical and health sciencesmedicineHumansCapecitabineAgedNeoplasm StagingRetrospective StudiesRadiotherapybusiness.industryRectal Neoplasmsmedicine.diseaseColorectal cancerRadiation therapyGastrointestinal TractConcomitantRadiotherapy AdjuvantbusinessOrgan Sparing TreatmentsChemoradiotherapyFollow-Up Studiesdescription
Purpose To evaluate the influence of radiation dose on tumor regression grade (TRG) and sphincter preservation rate in a series of cT3N0-1 rectal cancer patients treated with neoadjuvant chemoradiotherapy (CT-RT) with or without a sequential radiation boost. Materials and methods Between May 2002 and September 2013, 116 cases were eligible for retrospective evaluation. Radiotherapy was delivered for a total dose of 45 Gy (no boost arm) or 50.4 Gy (boost arm). TRG was evaluated with the Dworak scale. Results Median follow-up was 62 months (range, 12-138 months). The 5-year overall survival and local control rates were 72% and 93%, respectively. Fifty-five patients (47%) were treated with a sequential radiation boost and 61 (53%) without a boost. Eighty patients (72%) presented T3N0 disease and 32 (28%) T3N1 disease. Concomitant capecitabine was administered in 92 cases (79%) and intravenous 5-fluorouracil in 24 cases (21%). Sphincter preservation was performed in 82% of patients in the boost arm and 66% in the no-boost arm. A higher TRG was related to a longer interval between neoadjuvant treatment and surgery (p<0.001). The probability of a TRG ≥2 was 2.5 times higher in the boost arm. A gain in local control, estimated at 4% during the first 3 years after CT-RT, favored the boost arm. Conclusions The long-term results from our single-center experience confirm literature data on the role of a sequential boost in tumor response after neoadjuvant CT-RT in a series of cT3N0-1 rectal cancer patients.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2016-01-29 | Tumori |