Oncotarget

Clinical Research Papers:

Preoperative short- vs. long-course chemoradiotherapy with delayed surgery for locally advanced rectal cancer

Mi Joo Chung, Dong Wook Kim, Weon Kuu Chung _, Suk Hwan Lee, Seung- Kyu Jeong, Jae Kwan Hwang and Choon Sik Jeong

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Oncotarget. 2017; 8:60479-60486. https://doi.org/10.18632/oncotarget.10280

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Abstract

Mi Joo Chung1, Dong Wook Kim1,*, Weon Kuu Chung1, Suk Hwan Lee2, Seung- Kyu Jeong3, Jae Kwan Hwang4 and Choon Sik Jeong5

1Department of Radiation oncology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea

2Department of Surgery, Kyung Hee University School of Medicine, Seoul, Korea

3Department of Surgery, Yang Hospital, Seoul, Korea

4Department of Surgery, Yang Hospital, Namyangju, Korea

5Department of Surgery, Hansol Hospital, Seoul, Korea

*Co-first authors, these authors contributed equally to this work

Correspondence to:

Weon Kuu Chung, email: [email protected]

Keywords: chemoradiotherapy, preoperative treatment, rectal cancer

Received: March 04, 2016     Accepted: June 07, 2016     Published: June 24, 2016

ABSTRACT

Purpose: To compare the clinical outcomes between short-course chemoradiotherapy (CRT) and long-course CRT with delayed surgery in locally advanced rectal cancer patients.

Results: From 2010 to 2015, 19 patients were treated with short-course CRT and 53 patients were treated with LCRT. The sphincter-saving rate (89.5% vs. 94.3%, short-course CRT vs. long-course CRT), pathologic complete remission (21.1% vs. 13.2%), downstaging (47.4% vs. 26.4%), and treatment complications including anastomotic site leakage, bowel adhesion, and hematologic toxicity associated with short-course CRT were not significantly different from those associated with long-course CRT. 2-year overall survival was 90.0% and 91.2% (p = 0.448), respectively.

Methods and materials: 72 patients with stage cT3-4N0-2M0 rectal cancer participated in a multicenter study. Short-course CRT treatment was as follows: a total of 25 Gy of radiotherapy was delivered in 5 equal doses with intensity modulated radiation therapy. Chemotherapy was consisted of Leucovorin 400 mg/m² administered by bolus injection on day 1 and 5-Fluouracil 1200 mg/m² given by continuous infusion on days 1 and 2. An additional three cycles of chemotherapy were administered before the surgery. Long-course CRT treatment was as follows: a total of 50.4 Gy of radiotherapy was delivered in 28 equal doses. Chemotherapy consisted of a bolus injection of 5-Fluouracil + Leucovorin during the first and last week of radiotherapy. Surgery was performed 6−8 weeks after completion of radiotherapy in both groups.

Conclusions: Preoperative short-course CRT is an effective and safe modality. It is clinically comparable to long-course CRT in locally advanced rectal cancer.


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