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Neoadjuvant intermediate-course versus long-course chemoradiotherapy in T3-4/N0+rectal cancer:Istanbul R-02 phase II randomized study

引用

Oncology Research 2023年第5期31卷 689-696页

作者： SUKRAN SENYUREK SEZER SAGLAM ESRA KAYTAN SAGLAM HAKAN YANAR KAAN GOK DIDEM TASTEKIN CANAN KOKSAL AKBAS NERGIZ dagoglu SAKIN gulbiz dagoglu kartal EMRE BALIK METIN KESKIN YASEMIN SANLI MINE GULLUOGLU ZULEYHA AKGUN Department of Radiation Oncology Koc University School of MedicineIstanbul34450Türkiye Department of Medical Oncology Demiroglu Bilim University Faculty of MedicineIstanbul34394Türkiye Department of Radiation Oncology Istanbul University Oncology InstituteIstanbul34093Türkiye Department of General Surgery Istanbul University Istanbul Faculty of MedicineIstanbul34093Türkiye Department of Medical Oncology Istanbul University Oncology InstituteIstanbul34093Türkiye Department of Medical Physics Istanbul University Oncology InstituteIstanbul34093Türkiye Department of Radiology Istanbul University Istanbul Faculty of MedicineIstanbul34093Türkiye Department of General Surgery Koc University School of MedicineIstanbul34450Türkiye Department of Nuclear Medicine Istanbul University Istanbul Faculty of MedicineIstanbul34093Türkiye Department of Pathology Istanbul University Istanbul Faculty of MedicineIstanbul34093Türkiye Department of Radiation Oncology Memorial Sisli HospitalIstanbul34384Türkiye

Radiation therapy(RT)is typically applied using one of two standard approaches for preoperative treatment of resectable locally advanced rectal cancer(LARC):short-course RT(SC-RT)alone or long-course RT(LC-RT)with concurrent fluorouracil(5-FU)*** Phase II single-arm KROG 11-02 study using intermediate-course(IC)(33 Gy(Gray)/10 fr(fraction)with concurrent capecitabine)preoperative chemoradiotherapy(CRT)demonstrated a pathologically complete response rate and a sphincter-sparing rate that were close to those of *** current trial aim to compare the pathological/oncological outcomes,toxicity,and quality of life results of LC-CRT and IC-CRT in cases of *** prescribed dose was 33 Gy/10 fr for the IC-CRT group and 50.4 Gy/28 fr for the LC-CRT *** chronomodulated capecitabine(Brunch regimen)1650 mg/m2/daily chemotherapy treatment was applied in both *** European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Colorectal Cancer Module(EORTC QLQ-CR29)was administered at baseline and at three and six months after CRT.A total of 60 patients with LARC randomized to receive IC-CRT(n=30)or LC-CRT(n=30)were included in this phase II randomized *** significant difference was noted between groups in terms of pathological outcomes,including pathological response rates(ypT0N0-complete response:23.3%vs.16.7%,respectively,and ypT0-2N0-downstaging:50%for each;p=0.809)and Dworak score-based pathological tumor regression grade(Grade 4-complete response:23.3 vs.16.7%,p=0.839).The 5-year overall survival(73.3 vs.86.7%,p=0.173)rate was also *** acute radiation dermatitis(p<0.001)and any hematological toxicity(p=0.004)rates were significantly higher in the LC-CRT group,while no significant difference was noted between treatment groups in terms of baseline,third month,and sixth month EORTC QLQ-CR29 scores.

关键词： Chemoradiotherapy Rectal cancer Neoadjuvant therapy

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