Two-week course of preoperative radiotherapy for locally advanced rectal adenocarcinoma

Xiang Gao Zhu, Jin Luan Li, Xiao Fan Li, Yong Heng Li, Qian Yu Ni, Lin Wang, Shan Wen Zhang, Jin Gu, Yong Cai, Chi Lin

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Objectives: To evaluate local control and survival in locally advanced rectal adenocarcinoma patients who underwent a preoperative 2-week course of radiotherapy (RT) and to identify prognostic factors influencing the survival rate. Methods: We analyzed 377 consecutively treated patients with locally advanced (T3/T4 or node positive) rectal adenocarcinoma. All patients underwent a preoperative 2-week course of RT (30 Gy in 10 fractions) followed by curative surgery. Regression model was used to examine prognostic factors for the disease-free survival (DFS) and overall survival (OS) rates. The Statistical Analysis System software package, version 9.3, was used for analysis. Results: The median follow-up for all living patients was 63.8 months (range, 5.1 to 131.7). The 5-year DFS and OS rates were 64.5% (95% CI, 59.0-69.4) and 75.6% (95% CI, 70.5-80.0), respectively. The 5-year cumulative incidences of local recurrence and distant metastases were 5.4% (95% CI, 2.9-7.9) and 29.0% (95% CI, 23.9-30.1), respectively. The pathologic complete response rate was achieved in 17 patients (4.5%). The Multivariate Cox Regression model showed that factors affecting DFS were the surgical technique, pre-RT pathologic grade, ypT, ypN, and comorbidity; and factors improving OS were low anterior resection, low pre-RT grade, low ypT, and low ypN. Conclusions: Patients treated with preoperative RT with 30 Gy in 10 fractions had similar local control, 5-year DFS and OS to reported long course RT regimen. The surgical technique, pre-RT pathologic grade, ypT, and ypN seemed to affect the OS. Further study on combining a 2-week course of preoperative RT with concurrent chemotherapy would be warranted.

Original languageEnglish (US)
Pages (from-to)266-273
Number of pages8
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume40
Issue number3
DOIs
StatePublished - May 1 2017

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Keywords

  • preoperative radiotherapy
  • prognostic factors
  • rectal adenocarcinoma
  • survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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