Treatment Patterns and Outcomes of Preoperative Neoadjuvant Radiotherapy in Patients with Early-onset Rectal Cancer.

Autor:	Badesha JK; BC Cancer, Vancouver, British Columbia, Canada.; The University of British Columbia, Vancouver, British Columbia, Canada., Zhou M; BC Cancer, Vancouver, British Columbia, Canada., Arif AA; BC Cancer, Vancouver, British Columbia, Canada.; The University of British Columbia, Vancouver, British Columbia, Canada., Gill S; BC Cancer, Vancouver, British Columbia, Canada.; The University of British Columbia, Vancouver, British Columbia, Canada., Speers C; BC Cancer, Vancouver, British Columbia, Canada., Peacock M; BC Cancer, Vancouver, British Columbia, Canada.; The University of British Columbia, Vancouver, British Columbia, Canada., De Vera MA; The University of British Columbia, Vancouver, British Columbia, Canada., Stuart HC; The University of British Columbia, Vancouver, British Columbia, Canada.; Vancouver General Hospital, Vancouver, British Columbia, Canada., Brown CJ; The University of British Columbia, Vancouver, British Columbia, Canada.; St. Paul's Hospital, Vancouver, British Columbia, Canada., Donellan F; The University of British Columbia, Vancouver, British Columbia, Canada.; Vancouver General Hospital, Vancouver, British Columbia, Canada., Loree JM; BC Cancer, Vancouver, British Columbia, Canada.; The University of British Columbia, Vancouver, British Columbia, Canada.
Jazyk:	angličtina
Zdroj:	Cancer research communications [Cancer Res Commun] 2023 Apr 06; Vol. 3 (4), pp. 548-557. Date of Electronic Publication: 2023 Apr 06 (Print Publication: 2023).
DOI:	10.1158/2767-9764.CRC-22-0385
Abstrakt:	Preoperative radiotherapy for early-stage rectal cancer has risks and benefits that may impact treatment choice in young patients. We reviewed radiotherapy use and outcomes for rectal cancer by age. Patients with early-stage rectal cancer in the Canadian province of British Columbia from 2002 to 2016 were identified ( n = 6,232). Baseline characteristics, treatment response, overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), and locoregional recurrence rate (LRR) were compared between patients <50 (early-onset; n = 532) and ≥50 years old (average-onset; n = 5,700). Early-onset patients were more likely to receive preoperative chemoradiotherapy than short-course radiotherapy [OR, 2.20; 95% confidence interval (CI), 1.67-2.89; P < 0.0001], but also had higher nodal ( P = 0.00096) and overall clinical staging ( P = 0.033). Cancer downstaging and pathologic complete response rates were similar in those receiving neoadjuvant chemoradiotherapy by age. Early-onset and average-onset patients had similar DSS ( P = 0.91) and DFS ( P = 0.27) in multivariate analysis unless non-colorectal deaths, which were higher in older patients, were censored in the DFS model (HR, 1.30; 95% CI, 1.01-1.68; P = 0.042). LRR also did not differ between age groups ( P = 0.88). Outcomes did not differ based on radiotherapy type. Young patients with rectal cancer are more likely to present with higher staging and receive long-course chemoradiotherapy. DSS did not differ by age group; however, young patients had worse DFS when we censored competing risks of death in older patients. Significance: This population-based study suggests younger patients are more likely to receive chemoradiotherapy, potentially due to higher stage at diagnosis, and response is comparable by age. (© 2023 The Authors; Published by the American Association for Cancer Research.)
Databáze:	MEDLINE
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