Tumor Response and Its Impact on Treatment Failure in Rectal Cancer: Does Intensity of Neoadjuvant Treatment Matter?

Autor: Diefenhardt M; Department of Radiotherapy and Oncology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt, Germany.; Frankfurt Cancer Institute (FCI), University Hospital, Goethe University Frankfurt, 60590 Frankfurt, Germany., Martin D; Department of Radiotherapy and Oncology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt, Germany.; Frankfurt Cancer Institute (FCI), University Hospital, Goethe University Frankfurt, 60590 Frankfurt, Germany.; Partner Site Frankfurt, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), 60590 Frankfurt, Germany., Fleischmann M; Department of Radiotherapy and Oncology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt, Germany., Hofheinz RD; Department of Medical Oncology, University Hospital Mannheim, University Heidelberg, 68167 Mannheim, Germany., Ghadimi M; Department of General, Visceral and Pediatric Surgery, University Medical Center, University Göttingen, 37099 Göttingen, Germany., Rödel C; Department of Radiotherapy and Oncology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt, Germany.; Frankfurt Cancer Institute (FCI), University Hospital, Goethe University Frankfurt, 60590 Frankfurt, Germany.; Partner Site Frankfurt, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), 60590 Frankfurt, Germany., Fokas E; Department of Radiotherapy and Oncology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt, Germany.; Frankfurt Cancer Institute (FCI), University Hospital, Goethe University Frankfurt, 60590 Frankfurt, Germany.; Partner Site Frankfurt, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), 60590 Frankfurt, Germany.; Department of Radiation Oncology, Cyberknife and Radiation Therapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Köln, Germany.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2024 Oct 30; Vol. 16 (21). Date of Electronic Publication: 2024 Oct 30.
DOI: 10.3390/cancers16213673
Abstrakt: Objectives: Additional adjuvant treatment in patients with rectal cancer with limited response to neoadjuvant treatment to mitigate their higher risk of treatment failure remains controversial. Methods: This is a post hoc analysis of a cohort study of 3 randomized phase 2 or 3 trials (CAO/ARO/AIO-94, -04, and -12 trial) that included 1948 patients with locally advanced rectal adenocarcinoma. After excluding patients with missing information, 1788 patients (1254 men and 524 women; median age: 62.6 years, age range: 19-84 years) were eligible. We analyzed the extent of tumor response and its association with the incidence of treatment failure after different neoadjuvant treatment approaches. Results: Tumor response was significantly enhanced with more intensive neoadjuvant treatment. After a median follow-up of 55 months for the entire cohort (IQR: 37 months-62 months), the incidence of treatment failure (TF) stratified by tumor response or post-neoadjuvant pathological outcome was not significantly affected by the intensity of neoadjuvant treatment, whereas the ypTNM stage was significantly associated with the risk of treatment failure. Conclusions: In this cohort study, we provide evidence that limited or no response to intensified neoadjuvant treatment protocols is not likely to be more strongly associated with an extensive risk of TF after 5-FU CRT+/- adjuvant chemotherapy.
Databáze: MEDLINE
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