Long-Term Outcomes in Patients With Locally Advanced Rectal Cancer Following R1 Resection After Either Induction Chemotherapy and Chemoradiotherapy or Chemoradiotherapy Alone

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical colorectal cancer Pub Date : 2024-10-05 DOI:10.1016/j.clcc.2024.09.003

Ellen Hein Nordvig , Gull-Mai Bergliot Grønbæk , Zahra Khalid Al-Uboody , Jakob Lykke , Jakob Hagen Vasehus Schou , Laurids Østergaard Poulsen

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引用次数: 0

Abstract

Introduction

Total neoadjuvant treatment (TNT) with induction chemotherapy (ICT) followed by chemoradiotherapy (CRT) has improved long-term outcomes for patients with locally advanced rectal cancer (LARC). However, long-term outcomes have not been investigated for patients with incomplete (R1) resection separately. This study investigates overall survival (OS), disease-free survival (DFS) and local and distant recurrence rates in patients with R1 resection after preoperative treatment with ICT and CRT or CRT.

Patients and methods

From the NORD database 689 patients with LARC who received treatment between 2006 and 2017 were screened for inclusion. All patients with R1 resection were included. ICT consisted of at least 1 cycle of capecitabine and oxaliplatin (CAPOX) and was followed by radiotherapy concomitant with capecitabine.

Results

Among 46 patients with R1 resection, 27 (59%) received both ICT and CRT, and 19 (41%) patients received CRT. The 5-year OS was 44% (95% CI, 26%-63%) (ICT + CRT) versus 37% (95% CI, 15%-59%) (CRT) (P = .25) and 5-year DFS was 44% (95% CI, 26%-63%) (ICT + CRT) versus 32% (95% CI, 11%-53%) (CRT) (P = .22). The local recurrence rates showed a small nonstatistical significant difference in local control in the ICT group: 15% compared to 26% in the CRT group (P = .22). Distant recurrence rates were similar: 41% (ICT + CRT) versus 47% (CRT) (P = .48).

Conclusion

There was no significant difference in OS, DFS or local and distant recurrence rates between patients who received ICT + CRT versus patients who received CRT only.

查看原文本刊更多论文

局部晚期直肠癌患者在诱导化疗和化疗放疗或单独化疗放疗后进行 R1 切除术的长期疗效。

简介：采用诱导化疗（ICT）和化放疗（CRT）的全新辅助治疗（TNT）改善了局部晚期直肠癌（LARC）患者的长期疗效。然而，尚未对不完全（R1）切除患者的长期疗效进行单独研究。本研究调查了R1切除患者术前接受ICT和CRT或CRT治疗后的总生存期（OS）、无病生存期（DFS）以及局部和远处复发率：从NORD数据库中筛选出689名在2006年至2017年间接受治疗的LARC患者。所有R1切除的患者均纳入其中。ICT包括至少一个周期的卡培他滨和奥沙利铂（CAPOX），之后在使用卡培他滨的同时进行放疗：在46例R1切除术患者中，27例（59%）同时接受了ICT和CRT治疗，19例（41%）接受了CRT治疗。5年OS为44%（95% CI，26%-63%）（ICT + CRT）对37%（95% CI，15%-59%）（CRT）（P = .25），5年DFS为44%（95% CI，26%-63%）（ICT + CRT）对32%（95% CI，11%-53%）（CRT）（P = .22）。局部复发率显示，ICT 组在局部控制方面存在微小的非统计学显著差异：15% 而 CRT 组为 26% (P = .22)。远处复发率相似：41%（ICT + CRT）对47%（CRT）（P = .48）：结论：接受ICT + CRT治疗的患者与仅接受CRT治疗的患者在OS、DFS或局部和远处复发率方面没有明显差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical colorectal cancer 医学-肿瘤学

CiteScore

5.50

自引率

2.90%

发文量

审稿时长

27 days

期刊介绍： Clinical Colorectal Cancer is a peer-reviewed, quarterly journal that publishes original articles describing various aspects of clinical and translational research of gastrointestinal cancers. Clinical Colorectal Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of colorectal, pancreatic, liver, and other gastrointestinal cancers. The main emphasis is on recent scientific developments in all areas related to gastrointestinal cancers. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.