AIM: To evaluate the prognostic factors and impact on survival of neoadjuvant oral and infusional chemoradiotherapy in patients with locally advanced rectal cancer. BACKGROUND: There is still no definitive consensus about the prognostic factors and the impact of neoadjuvant chemoradiotherapy on survival. Some studies have pointed to an improvement in overall survival (OS) and progression-free survival (PFS) in patients with tumor downstaging (TD) and nodal downstaging (ND). MATERIALS AND METHODS: A set of 159 patients with LARC were treated preoperatively. Group A - 112 patients underwent concomitant oral chemoradiotherapy: capecitabine or UFT + folinic acid. Group B - 47 patients submitted to concomitant chemoradiation with 5-FU in continuous infusion. 63.6% of patients were submitted to adjuvant chemotherapy. GROUP A: pathologic complete response (pCR) - 18.7%; TD - 55.1%; ND - 76%; loco-regional response - 74.8%. Group B: pCR - 11.4%; TD - 50%; ND - 55.8%; LRR - 54.5%. The loco-regional control was 95.6%. There was no difference in survival between both groups. Those with loco-regional response had better PFS. CONCLUSIONS: Tumor and nodal downstaging, loco-regional response and a normal CEA level turned out to be important prognostic factors in locally advanced rectal cancer. Nodal downstaging and loco-regional response were higher in Group A. Those with tumor downstaging and loco-regional response from Group A had better OS. Adjuvant chemotherapy had no impact on survival except in those patients with loco-regional response who achieved a higher PFS.
AIM: To evaluate the prognostic factors and impact on survival of neoadjuvant oral and infusional chemoradiotherapy in patients with locally advanced rectal cancer. BACKGROUND: There is still no definitive consensus about the prognostic factors and the impact of neoadjuvant chemoradiotherapy on survival. Some studies have pointed to an improvement in overall survival (OS) and progression-free survival (PFS) in patients with tumor downstaging (TD) and nodal downstaging (ND). MATERIALS AND METHODS: A set of 159 patients with LARC were treated preoperatively. Group A - 112 patients underwent concomitant oral chemoradiotherapy: capecitabine or UFT + folinic acid. Group B - 47 patients submitted to concomitant chemoradiation with 5-FU in continuous infusion. 63.6% of patients were submitted to adjuvant chemotherapy. GROUP A: pathologic complete response (pCR) - 18.7%; TD - 55.1%; ND - 76%; loco-regional response - 74.8%. Group B: pCR - 11.4%; TD - 50%; ND - 55.8%; LRR - 54.5%. The loco-regional control was 95.6%. There was no difference in survival between both groups. Those with loco-regional response had better PFS. CONCLUSIONS:Tumor and nodal downstaging, loco-regional response and a normal CEA level turned out to be important prognostic factors in locally advanced rectal cancer. Nodal downstaging and loco-regional response were higher in Group A. Those with tumor downstaging and loco-regional response from Group A had better OS. Adjuvant chemotherapy had no impact on survival except in those patients with loco-regional response who achieved a higher PFS.
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Authors: N A Janjan; V S Khoo; J Abbruzzese; R Pazdur; R Dubrow; K R Cleary; P K Allen; P M Lynch; G Glober; R Wolff; T A Rich; J Skibber Journal: Int J Radiat Oncol Biol Phys Date: 1999-07-15 Impact factor: 7.038
Authors: P Piedbois; P Rougier; M Buyse; J Pignon; L Ryan; R Hansen; B Zee; B Weinerman; J Pater; C Leichman; J Macdonald; J Benedetti; J Lokich; J Fryer; G Brufman; R Isacson; A Laplanche; E Levy Journal: J Clin Oncol Date: 1998-01 Impact factor: 44.544
Authors: Nam Kyu Kim; Seung Hyuk Baik; Jin Sil Seong; Hoguen Kim; Jae Kyung Roh; Kang Young Lee; Seung Kook Sohn; Chang Hwan Cho Journal: Ann Surg Date: 2006-12 Impact factor: 12.969
Authors: Alejandro de la Torre; Maria Isabel García-Berrocal; Fernando Arias; Alfonso Mariño; Francisco Valcárcel; Rosa Magallón; Carlos A Regueiro; Jesús Romero; Irma Zapata; Cristina de la Fuente; Eva Fernández-Lizarbe; Gloria Vergara; Belén Belinchón; Maria Veiras; Rafael Molerón; Isabel Millán Journal: Int J Radiat Oncol Biol Phys Date: 2007-09-14 Impact factor: 7.038
Authors: Laura Cerezo; Juan Pablo Ciria; Leire Arbea; Olga Liñán; Sergio Cafiero; Vincenzo Valentini; Francesco Cellini Journal: Rep Pract Oncol Radiother Date: 2013-10-03