Chemoradiation in rectal squamous cell carcinoma: Bi-institutional case series

Gokoulakrichenane Loganadane,Stéphanie Servagi-Vernat,Antoine Schernberg,Michel Schlienger,Emmanuel Touboul,Jean-François Bosset,Florence Huguet

doi:10.1016/j.ejca.2016.02.005

Gokoulakrichenane Loganadane, Stéphanie Servagi-Vernat + Show 5 more

Open Access

https://doi.org/10.1016/j.ejca.2016.02.005

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Abstract

Background and purposePrimary rectal squamous cell carcinoma (SCC) is an uncommon disease. Early reports stated that surgery is the most effective treatment. However, recent publications suggest conservative strategy with chemoradiation provides satisfactory results. Patients and methodsWe have retrospectively studied the medical charts of 23 patients treated for a rectal SCC in two teaching hospitals in France between 1992 and 2013. Twenty-one patients received an exclusive chemoradiotherapy (CRT) and two a pre-operative CRT followed by a planned surgery. Patients received pelvic irradiation with a dose ranging from 36–45 Gy followed by a boost of 15–23 Gy. Twenty-two patients received a concurrent chemotherapy. ResultsAfter CRT, the rate of clinical complete response was 83%. With a median follow-up of 85 months, 5-year overall survival rate was 86%. Five patients presented with a relapse. The 5-year disease-free survival rate was 81%. The 5-year colostomy-free survival rate was 65%. Three patients (13%) presented with grade III–IV late rectal toxicity. ConclusionsAlthough retrospective, this is the largest cohort of patients treated with CRT for a rectal SCC. Exclusive CRT could result in high local control rate and prolonged survival in rectal SCC patients with a high rate of organ preservation.

Highlights

Colorectal carcinoma is the third leading cause of death due to cancer worldwide
Rectal squamous cell carcinoma (SCC) is an orphan disease with the four largest cases series reported by MSKCC [10], M.D
Several concurrent chemotherapy regimens were given to our patients but mostly consisted of 5FU and cisplatin that was the preferred regimen in France for anal SCC before the final results of Intergroup RTOG 9811 phase III trial [23]

Summary

Introduction

Squamous cell carcinoma (SCC) is an extremely rare subtype accounting for 0.1 to 0.25% of colorectal tumours. Radical surgery is limited to patients without response after CRT or at the time of relapse. This retrospective study aims to assess the outcome of patients with rectal SCC treated with CRT in two French university hospitals. Primary rectal squamous cell carcinoma (SCC) is an uncommon disease. Conclusions: retrospective, this is the largest cohort of patients treated with CRT for a rectal SCC. Exclusive CRT could result in high local control rate and prolonged survival in rectal SCC patients with a high rate of organ preservation

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Conclusion