Rapid Initiation of Neoadjuvant Chemoradiotherapy After Diagnosis is Associated With Improved Pathologic Response in Locally Advanced Rectal Cancer
| Autor: | Ilit Turgeman, Myroslav Lutsyk, Gil Bar-Sela |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Colorectal cancer medicine.medical_treatment Locally advanced Logistic regression Gastroenterology Disease-Free Survival Time-to-Treatment Capecitabine Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Aged Retrospective Studies business.industry Rectal Neoplasms Retrospective cohort study Chemoradiotherapy Middle Aged medicine.disease Primary tumor Neoadjuvant Therapy Radiation therapy Treatment Outcome Oncology Female Fluorouracil business medicine.drug Neoadjuvant chemoradiotherapy |
| Zdroj: | American journal of clinical oncology. 45(1) |
| ISSN: | 1537-453X |
| Popis: | INTRODUCTION In rectal cancer, neoadjuvant chemoradiation (NCRT) is preferred because of toxicity profile, improved resectability and sphincter preservation, although with no impact on overall survival. Pathologic complete response (pCR) to NCRT has been linked with longer disease-free survival (DFS). The study purpose was to evaluate an association between clinical factors and treatment schedule with tumor response and treatment outcome, among patients with locally advanced rectal cancer. PATIENTS AND METHODS In this single-center retrospective study, conducted over 9 years (2011 to 2020), patients with stage II to III rectal cancer who had received NCRT were enrolled. The standard radiotherapy was 45 Gy to the pelvis, with a simultaneous integrated 50 Gy boost to the primary tumor. Continuous 5-Fluorouracil or oral capecitabine was administered concurrently. Surgery was preplanned within 6 to 8 weeks. Multinomial logistic regressions for evaluation of clinical factors, Kaplan-Meier method for DFS estimation, and receiver operating characteristic analysis for determination of the optimal timeframe were used. RESULTS Of 279 cases, pCR was observed in 72 (25.8%). In 207 cases, pTis-4N-negative was obtained in 137 (66.2%), pT0N-positive in 6 (2.9%), and pTis-4N-positive in 64 (30.9%). The pCR group had shorter diagnosis-NCRT time (P |
| Databáze: | OpenAIRE |
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