Neoadjuvant Modified Short-Course Radiotherapy Followed by Delayed Surgery for Locally Advanced Rectal Cancer.
Hiroshi DoiHiroyuki YokoyamaNaohito BeppuMasayuki FujiwaraShogo HaruiAyako KakunoHidenori YanagiYoshio HishikawaNaoki YamanakaNorihiko KamikonyaPublished in: Cancers (2021)
This study aimed to assess the clinical outcomes and predictive factors of neoadjuvant modified short-course radiotherapy (mSC-RT) for locally advanced rectal cancer (LARC). Data from 97 patients undergoing mSC-RT followed by radical surgery for LARC were retrospectively analyzed. A 2.5 Gy dose twice daily up to a total dose of 25 Gy in 10 fractions was administered through mSC-RT, and this was delivered with oral chemotherapy in 95 (97.9%) patients. Radical surgery was performed 6 (range, 3-13) weeks after mSC-RT. The median follow-up among surviving patients was 43 (8-86) months. All patients completed neoadjuvant radiotherapy with no acute toxicity grade ≥ 3. Three- and five-year local control rates were 96.3% and 96.3%, respectively. Three- and five-year overall survival (OS) rates were 92.7% and 79.8%, respectively. Univariate analyses revealed that poor OS was associated with no concurrent administration of capecitabine, C-reactive-protein-to-albumin ratio ≥ 0.053, carcinoembryonic antigen ≥ 3.4 ng/mL, and neutrophil-to-lymphocyte ratio (NLR) ≥ 1.83 (P = 0.045, 0.001, 0.041, and 0.001, respectively). Multivariate analyses indicated that NLR ≥ 1.83 was independently associated with poor OS (p = 0.018). mSC-RT followed by delayed surgery for LARC was deemed feasible and resulted in good clinical outcomes, whereas poor OS was associated with high NLR.
Keyphrases
- locally advanced
- rectal cancer
- end stage renal disease
- minimally invasive
- ejection fraction
- newly diagnosed
- squamous cell carcinoma
- chronic kidney disease
- patients undergoing
- prognostic factors
- coronary artery bypass
- early stage
- peritoneal dialysis
- machine learning
- radiation induced
- atrial fibrillation
- clinical trial
- patient reported outcomes
- liver failure
- intensive care unit
- oxidative stress
- coronary artery disease
- respiratory failure
- percutaneous coronary intervention
- big data
- free survival
- electronic health record