Abstract
PurposeTo compare the clinical outcomes between short-course chemoradiotherapy (CRT) and long-course CRT with delayed surgery in locally advanced rectal cancer patients.ResultsFrom 2010 to 2015, 19 patients were treated with short-course CRT and 53 patients were treated with LCRT. The sphincter-saving rate (89.5% vs. 94.3%, short-course CRT vs. long-course CRT), pathologic complete remission (21.1% vs. 13.2%), downstaging (47.4% vs. 26.4%), and treatment complications including anastomotic site leakage, bowel adhesion, and hematologic toxicity associated with short-course CRT were not significantly different from those associated with long-course CRT. 2-year overall survival was 90.0% and 91.2% (p = 0.448), respectively.Methods and materials72 patients with stage cT3-4N0-2M0 rectal cancer participated in a multicenter study. Short-course CRT treatment was as follows: a total of 25 Gy of radiotherapy was delivered in 5 equal doses with intensity modulated radiation therapy. Chemotherapy was consisted of Leucovorin 400 mg/m2 administered by bolus injection on day 1 and 5-Fluouracil 1200 mg/m2 given by continuous infusion on days 1 and 2. An additional three cycles of chemotherapy were administered before the surgery. Long-course CRT treatment was as follows: a total of 50.4 Gy of radiotherapy was delivered in 28 equal doses. Chemotherapy consisted of a bolus injection of 5-Fluouracil + Leucovorin during the first and last week of radiotherapy. Surgery was performed 6−8 weeks after completion of radiotherapy in both groups.ConclusionsPreoperative short-course CRT is an effective and safe modality. It is clinically comparable to long-course CRT in locally advanced rectal cancer.
Highlights
IntroductionThe German Rectal Cancer Study Group reported that preoperative CRT improved local control and reduced treatment-associated toxicity in comparison with postoperative CRT [1]
Preoperative conventionally fractionated chemoradiotherapy(CRT) has been adopted as a standard treatment for patients with stage II or III rectal cancer.The German Rectal Cancer Study Group reported that preoperative CRT improved local control and reduced treatment-associated toxicity in comparison with postoperative CRT [1]
The sphincter-saving rate (89.5% vs. 94.3%, short-course CRT vs. long-course CRT), pathologic complete remission (21.1% vs. 13.2%), downstaging (47.4% vs. 26.4%), and treatment complications including anastomotic site leakage, bowel adhesion, and hematologic toxicity associated with short-course CRT were not significantly different from those associated with longcourse CRT. 2-year overall survival was 90.0% and 91.2% (p = 0.448), respectively
Summary
The German Rectal Cancer Study Group reported that preoperative CRT improved local control and reduced treatment-associated toxicity in comparison with postoperative CRT [1]. The Dutch Colorectal Cancer Group and the Swedish Rectal Cancer Trial demonstrated the value of short-course radiotherapy (5 × 5 Gy). Both trials reported that www.impactjournals.com/oncotarget short-course radiotherapy led to a reduction in the risk of local recurrence [2]. Complete remission as reported in a Polish trial and in the Tans-Tasman Radiation Oncology Group Trial (TROG) 01.04 was significantly higher after CRT than after short-course radiotherapy [8]
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