Jun Seok Park1, Min Kyu Kang2, Seung Ho Song3, Gyu-Seog Choi3, Soo Yeun Park3, Hye Jin Kim3, Jong Gwang Kim4, Byung Woog Kang4, Jin Ho Baek4, Dong Won Baek4, Jae-Chul Kim5, Shin-Hyung Park5, Seung Hyun Cho6, An Na Seo7. 1. Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. parkjs0802@knu.ac.kr. 2. Department of Radiation Oncology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. mkkang@knu.ac.kr. 3. Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. 4. Department of Hematology/Oncology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. 5. Department of Radiation Oncology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. 6. Department of Radiology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. 7. Department of Pathology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Abstract
PURPOSE: We analyzed the safety and feasibility of preoperative short-course radiotherapy (SCRT) followed by consolidation chemotherapy for patients with locally advanced rectal cancer (LARC). METHODS: From April 2018 to May 2019, 19 patients with LARC were treated with SCRT followed by three cycles of consolidation chemotherapy with leucovorin, fluorouracil, and oxaliplatin (FOLFOX6) before surgery. Adjuvant chemotherapy relied on oxaliplatin. Tumor response, patient compliance, and toxicities were analyzed. RESULTS: The median age was 60 years (range 44-71), and 16 of the patients were male. The median tumor height was 5 cm (range 0-9) from anal verge. All patients received a total dose of 25 Gy in five fractions. The number of cycles of FOLFOX6 before surgery was three in 17, four in one, five in one. Five patients required dose reductions in consolidation chemotherapy. The median interval between initiation of SCRT and surgery was 10.6 weeks (range 8.6-16.4). A pathologic complete response was seen in two patients (11%). Grade III toxicities to the preoperative treatment were seen in five patients (26%): diarrhea in two, a decreased white blood cell count in one, and anemia in two. Postoperative complications arising within 30 days developed in five patients (26%). During the median follow-up period of 20.4 months, there was no tumor recurrence. CONCLUSION: Preoperative SCRT followed by oxaliplatin-based consolidation chemotherapy showed acceptable toxicity and feasibility in patients with LARC. Prospective randomized trials are warranted to verify the efficacy and safety of this treatment strategy compared with conventional long-course concurrent chemoradiotherapy.
PURPOSE: We analyzed the safety and feasibility of preoperative short-course radiotherapy (SCRT) followed by consolidation chemotherapy for patients with locally advanced rectal cancer (LARC). METHODS: From April 2018 to May 2019, 19 patients with LARC were treated with SCRT followed by three cycles of consolidation chemotherapy with leucovorin, fluorouracil, and oxaliplatin (FOLFOX6) before surgery. Adjuvant chemotherapy relied on oxaliplatin. Tumor response, patient compliance, and toxicities were analyzed. RESULTS: The median age was 60 years (range 44-71), and 16 of the patients were male. The median tumor height was 5 cm (range 0-9) from anal verge. All patients received a total dose of 25 Gy in five fractions. The number of cycles of FOLFOX6 before surgery was three in 17, four in one, five in one. Five patients required dose reductions in consolidation chemotherapy. The median interval between initiation of SCRT and surgery was 10.6 weeks (range 8.6-16.4). A pathologic complete response was seen in two patients (11%). Grade III toxicities to the preoperative treatment were seen in five patients (26%): diarrhea in two, a decreased white blood cell count in one, and anemia in two. Postoperative complications arising within 30 days developed in five patients (26%). During the median follow-up period of 20.4 months, there was no tumor recurrence. CONCLUSION: Preoperative SCRT followed by oxaliplatin-based consolidation chemotherapy showed acceptable toxicity and feasibility in patients with LARC. Prospective randomized trials are warranted to verify the efficacy and safety of this treatment strategy compared with conventional long-course concurrent chemoradiotherapy.
Entities:
Keywords:
Consolidation chemotherapy; Rectal cancer; Short-course radiotherapy; Total mesorectal excision
Authors: Rolf Sauer; Heinz Becker; Werner Hohenberger; Claus Rödel; Christian Wittekind; Rainer Fietkau; Peter Martus; Jörg Tschmelitsch; Eva Hager; Clemens F Hess; Johann-H Karstens; Torsten Liersch; Heinz Schmidberger; Rudolf Raab Journal: N Engl J Med Date: 2004-10-21 Impact factor: 91.245
Authors: Hye Jin Kim; Gyu-Seog Choi; Jun Seok Park; Soo Yeun Park; Hee Jae Lee; In Taek Woo; In Kyu Park Journal: Surg Endosc Date: 2017-11-09 Impact factor: 4.584
Authors: B Ciseł; L Pietrzak; W Michalski; L Wyrwicz; A Rutkowski; E Kosakowska; A Cencelewicz; M Spałek; W Polkowski; M Jankiewicz; R Styliński; M Bębenek; B Kapturkiewicz; A Maciejczyk; J Sadowski; J Zygulska; W Zegarski; M Jankowski; M Las-Jankowska; Z Toczko; U Żelazowska-Omiotek; L Kępka; J Socha; E Wasilewska-Tesluk; W Markiewicz; J Kładny; A Majewski; W Kapuściński; R Suwiński; K Bujko Journal: Ann Oncol Date: 2019-08-01 Impact factor: 32.976
Authors: Willem van Gijn; Corrie A M Marijnen; Iris D Nagtegaal; Elma Meershoek-Klein Kranenbarg; Hein Putter; Theo Wiggers; Harm J T Rutten; Lars Påhlman; Bengt Glimelius; Cornelis J H van de Velde Journal: Lancet Oncol Date: 2011-05-17 Impact factor: 41.316
Authors: Samuel Y Ngan; Bryan Burmeister; Richard J Fisher; Michael Solomon; David Goldstein; David Joseph; Stephen P Ackland; David Schache; Bev McClure; Sue-Anne McLachlan; Joseph McKendrick; Trevor Leong; Cris Hartopeanu; John Zalcberg; John Mackay Journal: J Clin Oncol Date: 2012-09-24 Impact factor: 44.544
Authors: Muhammed R S Siddiqui; Constantinos Simillis; Chris Hunter; Manish Chand; Jemma Bhoday; Aurelie Garant; Te Vuong; Giovanni Artho; Shahnawaz Rasheed; Paris Tekkis; Al-Mutaz Abulafi; Gina Brown Journal: Br J Cancer Date: 2017-04-27 Impact factor: 7.640
Authors: David Sebag-Montefiore; Richard J Stephens; Robert Steele; John Monson; Robert Grieve; Subhash Khanna; Phil Quirke; Jean Couture; Catherine de Metz; Arthur Sun Myint; Eric Bessell; Gareth Griffiths; Lindsay C Thompson; Mahesh Parmar Journal: Lancet Date: 2009-03-07 Impact factor: 79.321