Induction chemotherapy followed by long-course chemoradiotherapy versus short-course radiotherapy followed by consolidation chemotherapy for achieving complete response in patients with locally advanced rectal cancer: a propensity-score matching study.

IF 1.6 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-09-13 DOI:10.1007/s00595-025-03132-9

Kentaro Sato, Takashi Akiyoshi, Tatsuki Noguchi, Takashi Sakamoto, Shimpei Matsui, Toshiki Mukai, Tomohiro Yamaguchi, Masamichi Koyama, Senzo Taguchi, Akiko Chino, Hiroshi Kawachi, Eiji Shinozaki, Kensei Yamaguchi

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引用次数: 0

Abstract

Purpose: This study compared complete response (CR) outcomes between two total neoadjuvant therapy (TNT) strategies for locally advanced rectal cancer: induction chemotherapy followed by long-course chemoradiotherapy (INCT-LCCRT) versus short-course radiotherapy followed by consolidation chemotherapy (SCRT-CNCT).

Methods: The subjects of this retrospective study were 234 patients with clinical stage T3-4NanyM0 low rectal cancer, treated between 2011 and 2022 with TNT and either total mesorectal excision or non-operative management (NOM). CR was defined as pathological CR after resection or sustained clinical CR in NOM. Propensity score matching was applied to adjust baseline differences, resulting in 38 matched pairs. We evaluated CR rates and survival outcomes.

Results: There were 194 patients treated with INCT-LCCRT and 40 treated with SCRT-CNCT. The INCT-LCCRT group had more advanced disease features, including higher rates of clinical T4 (29.9% vs. 2.5%) and lateral pelvic node metastases (62.4% vs. 10%). The CR rates were comparable in the full cohort (30.9% vs. 30.0%, p = 1) and after matching (34.2% vs. 28.9%, p = 0.81). No significant differences were observed in 3-year relapse-free or local recurrence-free survival.

Conclusions: In the matched cohort of mainly intermediate-risk cases, INCT-LCCRT and SCRT-CNCT demonstrated comparable CR rates and oncological outcomes.

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局部晚期直肠癌患者诱导化疗后长期放化疗与短期放疗后巩固化疗实现完全缓解：一项倾向评分匹配研究

目的：本研究比较了局部晚期直肠癌的两种总新辅助治疗（TNT）策略的完全缓解（CR）结果：诱导化疗后长期放化疗（INCT-LCCRT）与短期放疗后巩固化疗（SCRT-CNCT）。方法：本回顾性研究的对象是234例2011 - 2022年间接受TNT治疗的临床分期T3-4NanyM0低位直肠癌患者，这些患者要么接受全肠系膜切除术，要么接受非手术治疗（NOM）。CR定义为切除后病理CR或NOM的持续临床CR。采用倾向评分匹配来调整基线差异，得到38对匹配。我们评估了CR率和生存结果。结果：INCT-LCCRT治疗194例，SCRT-CNCT治疗40例。INCT-LCCRT组有更晚期的疾病特征，包括更高的临床T4发生率（29.9%比2.5%）和骨盆外侧淋巴结转移（62.4%比10%）。全队列中（30.9% vs. 30.0%, p = 1）和配对后（34.2% vs. 28.9%, p = 0.81）的CR率具有可比性。3年无复发生存率和局部无复发生存率无显著差异。结论：在主要为中危病例的匹配队列中，INCT-LCCRT和SCRT-CNCT显示出相当的CR率和肿瘤预后。

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

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.