Addition of short course radiotherapy in newly diagnosed locally advanced rectal cancers with distant metastasis.
CT (chemotherapy)
SCRT (short course radiotherapy)
mLARC (metastatic locally advanced rectal cancer)
Journal
Asia-Pacific journal of clinical oncology
ISSN: 1743-7563
Titre abrégé: Asia Pac J Clin Oncol
Pays: Australia
ID NLM: 101241430
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
12
02
2019
accepted:
04
01
2020
pubmed:
8
2
2020
medline:
23
4
2021
entrez:
8
2
2020
Statut:
ppublish
Résumé
To study the outcomes of patients presenting with locally advanced rectal cancers with distant metastasis (mLARC), treated with short course radiotherapy (SCRT). Between May 2012 and August 2015, 70 patients diagnosed with mLARC, treated with SCRT (25 Gy/5#) and three to six cycles of CAPOX chemotherapy (CT), were assessed for surgical feasibility for the primary and metastatic sites. Sixty-five patients could complete the planned SCRT and three to six cycles of CT. Response rate and disease control rate for the primary was 68% and 97%, respectively. Radiologically, CRM became free in 44 (72%) patients out of 61 initially involved. Fifty-two (74%) were planned to receive treatment with a potentially curative intent and 18 (26%) with palliative intent. Of those treated with curative intent, 34 (65%) underwent primary tumor resection (PTR). Successful intervention for metastatic disease was done in 27 (52%) patients. At a median follow up of 43 months, the median overall survival (OS) for patients undergoing PTR was 36 months versus 12 months for those in which the tumor was still unresectable or had distant progression (P < .001). Of the operated patients, 56% were alive at the end of 3 years. The median pelvic recurrence free survival was 29 months. Symptom control in the form of pain and bleeding control was observed in 80%. The addition of SCRT to CT in mLARC can downstage the primary tumor to undergo surgery, thereby, achieving better loco-regional control and survival. It achieves good palliation in patients unable to undergo surgery due to extensive primary or metastatic disease.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e70-e76Informations de copyright
© 2020 John Wiley & Sons Australia, Ltd.
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