Trends in combined radio-chemotherapy for locally advanced rectal cancer: A survey among radiation oncology centers of sicily region on behalf of airo
| Autor: | Giovanni Cartia, Giuseppe Ferrera, Stefano Pergolizzi, M. Bono, Salvatore Bonanno, Roberto Milazzotto, Laura Molino, Lucia Ognibene, Roberto Ianni, Lorenza Marino, G. Mortellaro, P. Frosina, Luca Liardo, Corrado Spatola, Manuela Federico, Marilena Mattace Raso, Rosalba Salvo, Giuseppe Privitera, Marco Badalamenti, Anna Santacaterina, Angelo Platania, Antonino Daidone, Leonarda La Paglia, Antonella Tripoli, G. Evangelista, Alberto Cacciola, I. Fazio, Alessandra Tocco, Silvana Parisi, Grazia Acquaviva, Francesco Marletta, Alfio Di Grazia, Giampaolo Biti |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Neoadjuvant treatment medicine.medical_treatment Population Radio-chemotherapy Gastroenterology 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine AIRO Neoadjuvant treatment Radio-chemotherapy Rectal cancer Survey Radiology Nuclear Medicine and Imaging FOLFOX Internal medicine Surveys and Questionnaires Nuclear Medicine and Imaging Medicine Humans Radiology Nuclear Medicine and imaging Practice Patterns Physicians' Rectal cancer education Survey Sicily Societies Medical AIRO Aged Retrospective Studies Aged 80 and over education.field_of_study business.industry Rectal Neoplasms Induction chemotherapy Combination chemotherapy General Medicine Chemoradiotherapy Middle Aged Oxaliplatin Radiation therapy Regimen 030220 oncology & carcinogenesis Concomitant Radiation Oncology Female Radiology Nuclear Medicine and Imaging business Radiology medicine.drug |
| Popis: | To conduct a survey among Sicilian centers of radiation oncology belonging to Associazione Italiana di Radioterapia ed Oncologia Clinica (AIRO), to record the different methods of integration of radio-chemotherapy both in neoadjuvant and adjuvant settings, to evaluate surgical procedures in relation to the sphincter preservation and to report the different toxicity profiles of the treatment strategies. A questionnaire was sent at the end of 2017 to all the radiation oncology centers of Sicily region in order to collect the data from individual centers and the treatment characteristics retrospectively over the previous 5 years, from 2012 to 2016. The required data were collected from 13 centers out of 17 which, in relation to the single catchment areas, correspond to approximately 85% of the Sicilian population. The requested data concerned the type of integrated treatment (neoadjuvant vs adjuvant vs radical), combination with chemotherapy (induction, concomitant, adjuvant), type of surgical intervention (sphincter-saving vs abdomino-perineal resection), disease stage, schedule and radiotherapy technique adopted, as well as toxicity detected over the treatment period. A total of 784 pts (M/F: 509/275) were treated between 2012 and 2016, with a median age of 67 years (range 25–92). The majority of patients was treated in the neoadjuvant phase (62% of the total) compared to the adjuvant phase (31%) and to those treated radically (7%). Twenty-five percent of patients did not receive combination chemotherapy mainly for cardiovascular problems. Chemotherapy used concomitantly to radiotherapy was single-agent capecitabine (73% of patients) or 5-fluorouracil (27%). The use of chemotherapy alone before concomitant treatment is more common for patients treated in the adjuvant phase (64% of this subgroup), while 14% of patients treated in the neoadjuvant phase received induction chemotherapy before the concomitant phase; in both cases of chemotherapy alone, the majority of patients (91%) received oxaliplatin-based protocols (FOLFOX/XELOX/CAPOX). Few patients (3%) received chemotherapy alone after the concomitant phase. Information on the surgical treatment received is available for 88% of the sample. Of these, 93% received a surgical treatment. The overall rate of sphincter-saving surgery (anterior resection) was 72%, but the contribution of neoadjuvant treatment allowed to reach a rate of 83% in this subgroup (against 65% found in the subgroup of patients treated in adjuvant phase). Traditional radiotherapy schedule (45–50 Gy in 25–28 fractions) was used in 90% of patients, of which an intensified treatment in neoadjuvant phase (45 Gy + boost of 9–10 Gy) was used in 11% of patients. A short-course regimen (25 Gy in 5 fraction) in neoadjuvant setting was opted rarely (7%). Three-dimensional conformal technique was preferred over intensity-modulated ones (73% vs 27%). Toxicity was mainly of grade I–II CTCAE (skin 23%, gastrointestinal 39%, genitourinary 14%) compared to grade III (gastrointestinal 4%, genitourinary and hematological |
| Databáze: | OpenAIRE |
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