PO-108 Nonstandard hypofraction radiotherapy in neoadjuvant chemo-radiation therapy in treatment of locally advanced rectal cancer

Abstract

IntroductionNeoadjuvant chemoradiotherapy has become the standard treatment for locally advanced rectal cancer. Neoadjuvant chemoradiotherapy not only can reduce tumour size and recurrence, but also increase the tumour resection rate and anus retention rate with very slight side effect. Comparing with preoperative chemotherapy, preoperative chemoradiotherapy can further reduce the local recurrence rate and downstage.Material and methodsThe study of the efficacy of the developed neoadjuvant method of treatment of colorectal cancer with the use of remote nonstandard hypofraction radiotherapy SD 4 Gy every other day 3 fraction in week to achieve cumulative dose 36–40 Gy conducted in patients receiving capecitabine at a dose of 1700 mg/m2 during the entire course of radiation therapy (21 days), 3 infusion of oxaliplatin at a dose of 50 mg/m2 in 3, 10 and 17 days of treatment and 4–5 sessions of local microwave hyperthermia with course of metronidazole intrarectal administration radiosensitizing mixture consisting in 2 and 3 days of the course microwave hyperthermia. The treatment included 73 patients age of patients is from 45 to 68 with III stage (T3CD-4N0-2M0) of rectal cancer. (RT +CT + OXA+microwave hyperthermia+metronidazole). After a neoadjuvant treatment, all patients were operated in a radical amount within 7–8 weeks.Results and discussionsThe results of our study were as follows: complete clinical response in 33 patients, a partial response in 28 patients and the stabilisation of process in 12. In 33 patients due to clinical response was restaging disease. Postoperative complications were seen in 5 (6.8%) cases. In study group the use of preoperative nonstandard hypofraction radiotherapy in patients receiving capecitabine, oxaliplatin, microwave hyperthermia and metronidazole has increased the 5 year survival rate of up to 64.5%. The incidence of local recurrence was 37.6%, and the frequency of distant metastases of 21.8%ConclusionMethod of neoadjuvant treatment (RT +CT + OXA+microwave hyperthermia+metronidazole) in combination therapy of colorectal cancer in young patients does not affect intra-and postoperative complications and slightly increases the frequency of the 5 year survival. The hypofractive course of radiotherapy reduces the duration of radiotherapy and the duration of radiotherapy from 38 to 22 days compared with classical fractionation, which will favourably affect the financial situation and the quality of life of patients.