Pre-operative total neoadjuvant therapy in locally advanced rectal cancer patients: Initial results of Vietnamese patients.

Q2 Medicine

Clinica Terapeutica Pub Date : 2024-11-01 DOI:10.7417/CT.2024.5149

H H Nguyen, H H Nguyen, T H Nguyen, Q B Bui, H T Vu

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引用次数: 0

Abstract

Purpose: To evaluate the initial results of neoadjuvant chemoradiation followed by consolidation chemotherapy (total neoadjuvant therapy - TNT) in locally advanced rectal cancer (LARC) and its side effects.

Material and method: A prospective study in 75 patients with stage II and III rectal cancer at 108 Military Central Hospital and Nghe An Oncology Hospital from April 2022 to January 2024 who received total neoadjuvant therapy (preoperative chemoradiation of 50.4 Gy concurrent with Capecitabine 825 mg/m², twice a day for 5 days per week, then added neoadjuvant chemotherapy with the mFOLFOX6 or CAPEOX regimen) and subsequently underwent surgery.

Results: The median age was 60.07. Males accounted for 58.7%. Most patients in the study group exhibited tumor stage T3, accounting for 88.0% of the total. The percentages for lymph node stages N0, N1, and N2 were 14.7%, 40.0%, and 45.3%, respectively. 20.09% of patients exhibited a positive result for CRM on magnetic resonance imaging. CEA levels measured before and after using TNT were stati-stically significantly lower than before TNT. After treatment, 25 out of 75 patients (33.3%) had a pathological complete response (pCR). Side effects were mainly grade 1 or 2. Leukopenia was the most common side effect in both neoadjuvant chemoradiotherapy and consolidation chemotherapy. The patients underwent TME (60%), Miles (26.7%), LAR-RAR (12%), and ISR (1.3%). 10.6% of the patients experienced postoperative complications.

Conclusion: Total neoadjuvant therapy is an effective and safe treatment and results in acceptable rates of pathological complete response.

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局部晚期直肠癌患者术前全面新辅助治疗：越南患者的初步结果。

目的：评估局部晚期直肠癌（LARC）新辅助化放疗后巩固化疗（全新辅助治疗-TNT）的初步效果及其副作用：一项前瞻性研究：2022年4月至2024年1月期间，108军中心医院和义安肿瘤医院的75名II期和III期直肠癌患者接受了新辅助治疗（术前化放疗50.4 Gy，同时使用卡培他滨825 mg/m²，每天两次，每周5天，然后加入新辅助化疗mFOLFOX6或CAPEOX方案），随后接受了手术：中位年龄为 60.07 岁。男性占 58.7%。研究组中大多数患者的肿瘤分期为 T3，占总数的 88.0%。淋巴结分期为 N0、N1 和 N2 的比例分别为 14.7%、40.0% 和 45.3%。20.09%的患者在磁共振成像中显示出 CRM 阳性结果。在使用 TNT 之前和之后测量的 CEA 水平在统计学上明显低于 TNT 之前。治疗后，75名患者中有25人（33.3%）获得了病理完全反应（pCR）。副作用主要为1级或2级。白细胞减少是新辅助化放疗和巩固化疗中最常见的副作用。患者接受了TME（60%）、Miles（26.7%）、LAR-RAR（12%）和ISR（1.3%）治疗。10.6%的患者出现了术后并发症：结论：全新辅助治疗是一种有效、安全的治疗方法，可获得可接受的病理完全反应率。

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

Clinica Terapeutica PHARMACOLOGY & PHARMACY-

CiteScore

2.50

自引率

0.00%

发文量

124

审稿时长

6-12 weeks

期刊介绍： La Clinica Terapeutica è una rivista di Clinica e Terapia in Medicina e Chirurgia, fondata nel 1951 dal Prof. Mariano Messini (1901-1980), Direttore dell''Istituto di Idrologia Medica dell''Università di Roma “La Sapienza”. La rivista è pubblicata come “periodico bimestrale” dalla Società Editrice Universo, casa editrice fondata nel 1945 dal Comm. Luigi Pellino. La Clinica Terapeutica è indicizzata su MEDLINE, INDEX MEDICUS, EMBASE/Excerpta Medica.