Yan Yuan1,2, Wei-Wei Xiao1,2, Wei-Hao Xie1,2, Rong Zhang1,3, Yuan-Hong Gao4,5, Pei-Qiang Cai1,6, Qiao-Xuan Wang1,2, Hui Chang1,2, Bao-Qing Chen1,2, Wen-Hao Zhou1,7, Zhi-Fan Zeng1,2, Xiao-Jun Wu1,7, Qing Liu1,8, Li-Ren Li1,7. 1. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. 2. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China. 3. Department of Endoscopy and Laser, Sun Yat-sen University Cancer Center, Guangzhou, PR China. 4. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. gaoyh@sysucc.org.cn. 5. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China. gaoyh@sysucc.org.cn. 6. Departments of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, PR China. 7. Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, PR China. 8. Department of Epidemiology and Biostatistics, Sun Yat-sen University Cancer Center, Guangzhou, PR China.
Abstract
BACKGROUND: The management of unresectable locally advanced colon cancer (LACC) remains controversial, as resection is not feasible. The goal of this study was to evaluate the treatment outcomes and toxicity of neoadjuvant chemoradiotherapy (NACRT) followed with surgery and adjuvant chemotherapy in patients with unresectable radically LACC. METHODS: We included patients who were diagnosed at our institution, 2010-2018. The neoadjuvant regimen consisted of radiotherapy and capecitabine/ 5-fluorouracil-based chemotherapy. RESULTS: One hundred patients were identified. The median follow-up time was 32 months. The R0 resection rate, adjusted nonmultivisceral resection rate and bladder preservation rate were 83.0, 43.0 and 83.3%, respectively. The pCR and clinical-downstaging rates were 18, and 81.0%%, respectively. The 3-year PFS and OS rates for all patients were 68.6 and 82.1%, respectively. Seventeen patients developed grade 3-4 myelosuppression, which was the most common adverse event observed after NACRT. Tumor perforation occurred in 3 patients during NACRT. The incidence of grade 3-4 surgery-related complications was 7.0%. Postoperative anastomotic leakage was observed in 3 patients. CONCLUSIONS: NACRT followed by surgery was feasible and safe for selected patients with LACC, and can be used as a conversion treatment to achieve satisfactory downstaging, long-term survival and quality of life, with acceptable toxicities.
BACKGROUND: The management of unresectable locally advanced colon cancer (LACC) remains controversial, as resection is not feasible. The goal of this study was to evaluate the treatment outcomes and toxicity of neoadjuvant chemoradiotherapy (NACRT) followed with surgery and adjuvant chemotherapy in patients with unresectable radically LACC. METHODS: We included patients who were diagnosed at our institution, 2010-2018. The neoadjuvant regimen consisted of radiotherapy and capecitabine/ 5-fluorouracil-based chemotherapy. RESULTS: One hundred patients were identified. The median follow-up time was 32 months. The R0 resection rate, adjusted nonmultivisceral resection rate and bladder preservation rate were 83.0, 43.0 and 83.3%, respectively. The pCR and clinical-downstaging rates were 18, and 81.0%%, respectively. The 3-year PFS and OS rates for all patients were 68.6 and 82.1%, respectively. Seventeen patients developed grade 3-4 myelosuppression, which was the most common adverse event observed after NACRT. Tumor perforation occurred in 3 patients during NACRT. The incidence of grade 3-4 surgery-related complications was 7.0%. Postoperative anastomotic leakage was observed in 3 patients. CONCLUSIONS:NACRT followed by surgery was feasible and safe for selected patients with LACC, and can be used as a conversion treatment to achieve satisfactory downstaging, long-term survival and quality of life, with acceptable toxicities.
Authors: Devi Mukkai Krishnamurty; Alexander T Hawkins; Katerina O Wells; Matthew G Mutch; Mathew L Silviera; Sean C Glasgow; Steven R Hunt; Sekhar Dharmarajan Journal: J Gastrointest Surg Date: 2018-02-09 Impact factor: 3.452
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Authors: Lydia G M van der Geest; Jorine't Lam-Boer; Miriam Koopman; Cees Verhoef; Marloes A G Elferink; Johannes H W de Wilt Journal: Clin Exp Metastasis Date: 2015-04-22 Impact factor: 5.150
Authors: Alexander T Hawkins; Molly M Ford; Timothy M Geiger; M Benjamin Hopkins; Lisa A Kachnic; Roberta L Muldoon; Sean C Glasgow Journal: Surgery Date: 2018-07-14 Impact factor: 3.982