Time to surgery and pathologic complete response after neoadjuvant chemoradiation in rectal cancer: A population study on 2094 patients
| Autor: | Fabio Matrone, Maika di Benedetto, Giampaolo Montesi, Gabriella Macchia, Giuditta Chiloiro, Liliana Belgioia, E. Palazzari, R.M. Niespolo, Francesco Romeo Filippone, L. Giaccherini, M.E. Rosetto, Aldo Sainato, Salvatore Parisi, Luciana Caravatta, Antonino De Paoli, Mattia Falchetto Osti, Piera Sciacero, A. Fontana, Vincenzo Valentini, A. Caroli, Carlo Capirci, Caterina Boso, Lucia Turri, Alessio G. Morganti, Maria Antonietta Gambacorta, S. Montrone, Almalina Bacigalupo, Domenico Genovesi, Vincenzo Picardi, Alessandra Galardi, Carlotta Masciocchi, Marco Lupattelli, Giovanna Mantello |
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| Přispěvatelé: | Macchia, Gabriella, Gambacorta, Maria Antonietta, Masciocchi, Carlotta, Chiloiro, Giuditta, Mantello, Giovanna, di Benedetto, Maika, Lupattelli, Marco, Palazzari, Elisa, Belgioia, Liliana, Bacigalupo, Almalina, Sainato, Aldo, Montrone, Sabrina, Turri, Lucia, Caroli, Angela, De Paoli, Antonino, Matrone, Fabio, Capirci, Carlo, Montesi, Giampaolo, Niespolo, Rita Marina, Osti, Mattia Falchetto, Caravatta, Luciana, Galardi, Alessandra, Genovesi, Domenico, Rosetto, Maria Elena, Boso, Caterina, Sciacero, Piera, Giaccherini, Lucia, Parisi, Salvatore, Fontana, Antonella, Filippone, Francesco Romeo, Picardi, Vincenzo, Morganti, Alessio Giuseppe, Valentini, Vincenzo |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Colorectal cancer medicine.medical_treatment Urology R895-920 030230 surgery Article 03 medical and health sciences Medical physics. Medical radiology. Nuclear medicine 0302 clinical medicine Chemoradiation Rectal cancer Surgery TME Time interval Rectal Adenocarcinoma Medicine Radiology Nuclear Medicine and imaging Stage (cooking) RC254-282 Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA Chemotherapy business.industry Neoplasms. Tumors. Oncology. Including cancer and carcinogens Retrospective cohort study medicine.disease Total mesorectal excision Radiation therapy Oncology 030220 oncology & carcinogenesis Population study business |
| Zdroj: | Clinical and Translational Radiation Oncology, Vol 4, Iss C, Pp 8-14 (2017) Clinical and Translational Radiation Oncology |
| Popis: | Highlights • A large population based analysis to evaluate pathologic response according to time of surgery. • LARC patients were treated with modern techniques of radiotherapy and surgery. • The rate of pCR increased according to time interval from 12.6% to 31.1%. • The pCR increasing was 1.5% (about 0.2%/die) per each week of waiting. • Lengthening the interval (>13 weeks) significantly improved the pathological response. Background To retrospectively evaluate the difference in terms of pathologic complete response (pCR) according to time elapsed between chemoradiation (CRT) and total mesorectal excision (TME) on a large unselected real-life dataset of locally advanced rectal cancer (LARC) patients. Methods A multicentre retrospective cohort study of LARC patients from 21 Italian Radiotherapy Institutions was performed. Patients were stratified into 3 different time intervals from CRT. The 1st group included 300 patients who underwent TME within 6 weeks, the 2nd 1598 patients (TME within 7–12 weeks) and the 3rd 196 patients (TME within 13 or more weeks after CRT), respectively. Results Data on 2094 LARC patients treated between 1997 and 2016 were considered suitable for analysis. Overall, 578 patients had stage II while 1516 had stage III histological proven invasive rectal adenocarcinoma. A CRT schedule of one agent (N = 1585) or 2-drugs (N = 509) was administered. Overall, pCR was 22.3% (N = 468 patients). The proportion of patients achieving pCR with respect to time interval was, as follows: 12.6% (1st group), 23% (2nd group) and 31.1% (3rd group) (p 5040 cGy (p = 0.002) and longer interval (p 13 weeks) from CRT to surgery improves the pathological response (pCR and pathologic partial response; pPR) in comparison to historic data. Furthermore, radiotherapy dose >5040 cGy and two drugs chemotherapy correlated with pPR rate. |
| Databáze: | OpenAIRE |
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