Efficacy and Feasibility of Adding Induction Chemotherapy to Neoadjuvant Chemoradiation in Locally Advanced Rectal Cancer: A Phase II Clinical Trial
| Autor: | Maral Mokhtari, Mohammad Reza Sasani, Shapour Omidvari, Nezhat Khanjani, Seyed Hasan Hamedi, Niloofar Ahmadloo, Mansour Ansari, Alimohammad Bananzadeh, Sepideh Mirzaei, Ahmad Mosalaei, Mohammad Mohammadianpanah, Hamid Nasrolahi |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Surgical margin Neoadjuvant treatment Colorectal cancer Urology Rectal neoplasms RC799-869 Capecitabine 03 medical and health sciences 0302 clinical medicine Pathologic complete response medicine Radical surgery business.industry Gastroenterology Cancer Induction chemotherapy Diseases of the digestive system. Gastroenterology medicine.disease Oxaliplatin Regimen 030104 developmental biology 030220 oncology & carcinogenesis Surgery Original Article business medicine.drug |
| Zdroj: | Annals of Coloproctology Annals of Coloproctology, Vol 35, Iss 5, Pp 242-248 (2019) |
| ISSN: | 2287-9722 2287-9714 |
| Popis: | Purpose Currently, neoadjuvant chemoradiation (CRT) followed by total mesorectal resection is considered the standard of care for treating locally advanced rectal cancer. This study aimed to investigate the efficacy and feasibility of adding induction chemotherapy to neoadjuvant CRT in locally advanced rectal cancer. Methods This phase-II clinical trial included 54 patients with newly diagnosed, locally advanced (clinical T3–4 and/or N1–2, M0) rectal cancer. All patients were treated with 3 cycles of preoperative chemotherapy using the XELOX (capecitabine + oxaliplatin) regimen before and after a concurrent standard long course of CRT (45–50.4 Gy) followed by standard radical surgery. Pathologic complete response (PCR) rate and toxicity were the primary and secondary endpoints, respectively. Results The study participants included 37 males and 17 females, with a median age of 59 years (range, 20–80 years). Twenty-nine patients (54%) had clinical stage-II disease, and 25 patients (46%) had clinical stage-III disease. Larger tumor size (P = 0.006) and distal rectal location (P = 0.009) showed lower PCR compared to smaller tumor size and upper rectal location. Pathologic examinations showed significant tumor regression (6.1 ± 2.7 cm vs. 1.9 ± 1.8 cm, P < 0.001) with 10 PCRs (18.5%) compared to before the intervention. The surgical margin was free of cancer in 52 patients (96.3%). Treatment-related toxicities were easily tolerated, and all patients completed their planned treatment without interruption. Grade III and IV toxicities were infrequent. Conclusion The addition of induction chemotherapy to neoadjuvant CRT is an effective and well-tolerated treatment approach in patients with rectal cancer. |
| Databáze: | OpenAIRE |
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