Neoadjuvant Short-Course Radiotherapy Followed By Chemotherapy And Delayed Surgery For Locally Advanced Rectal Adenocarcinoma A Retrospective Analysis

Main Article Content

Mario Go, M.D.

Abstract

Introduction


Neoadjuvant concurrent chemoradiotherapy is an established treatment for locally advanced rectal adenocarcinoma. With the emerging adaptation of short-course radiotherapy as neoadjuvant regimen, the Polish Colorectal Study Group has provided a protocol with comparable outcomes.


Objectives


To compare short-term outcomes of patients with locally advanced rectal adenocarcinoma who underwent neoadjuvant adapted Polish II protocol versus standard long-course chemoradiotherapy, both followed by definitive surgery.


Methods


A chart review and analysis of patients with rectal adenocarcinoma between January 2016 to December 2017 with short-course radiotherapy followed by chemotherapy (adapted Polish II Protocol) were compared to patients who underwent long-course concurrent chemoradiotherapy. Acute toxicities were graded based on NCI/CTCAE and RTOG acute radiation scoring. Pathologic complete response (pCR) and resection margin status were used to assess pathologic outcomes. Overall survival and disease-free survival rates were assessed for short-term oncologic outcomes.


Results


Seven out of 16 (44%) underwent adapted Polish II protocol and the rest (9, 56%) underwent long-course protocol. Acute toxicities were comparable between groups, however, patients who underwent long-course treatment had higher grades of acute skin toxicity (p-value =0.004). Pathologic findings were comparable: one patient (14.3%) achieved pCR in short-course group, while none (0%) in long-course group; all patients (100%) had adequate resection margins in both groups. Long-course protocol group showed better short-term overall survival (34 months versus 26 months) and disease-free survival (p-value =0.509).


Conclusion


Achievement of pathologic complete response (pCR) and adequacy of resection margins as pathologic outcomes were comparable between neoadjuvant short-course and long-course chemoradiotherapy. Hence, adapting Polish II protocol as an alternative neoadjuvant treatment for locally advanced rectal adenocarcinoma has potential use in the local setting.

Article Details

How to Cite
GO, Mario. Neoadjuvant Short-Course Radiotherapy Followed By Chemotherapy And Delayed Surgery For Locally Advanced Rectal Adenocarcinoma. Philippine Radiation Oncology Society, [S.l.], nov. 2020. Available at: <https://research.pros.org.ph/index.php/pros/article/view/30>. Date accessed: 28 mar. 2024.
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