Neoadjuvant chemoradiation for distal rectal cancer: 5-year updated results of a randomized phase 2 study of neoadjuvant combined modality chemoradiation for distal rectal cancer.
Neoadjuvant chemoradiation for distal rectal cancer: 5-year updated results of a randomized phase 2 study of neoadjuvant combined modality chemoradiation for distal rectal cancer.
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DOI：
10.1016/j.ijrobp.2013.02.020
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发表时间：
2013-07-01
影响因子：
7
通讯作者：
Willett, Christopher
中科院分区：
文献类型：
--
作者：
Mohiuddin, Mohammed;Paulus, Rebecca;Mitchell, Edith;Hanna, Nader;Yuen, Albert;Nichols, Romaine;Yalavarthi, Salochna;Hayostek, Cherie;Willett, Christopher
To assess the efficacy of two different approaches to neoadjuvant chemo-radiation for distal rectal cancers. 106 patients with T3/T4 distal rectal cancers were randomized in a phase II study. Patients received either CVI 5-FU, 225 mg/m2 per day, 7 days per week plus pelvic hyperfractionated radiation (HRT) 45.6 Gy at 1.2 Gy bid plus a boost of 9.6 - 14.4 Gy for T3 or T4 cancers (Arm 1) or CVI 5-FU 225 mg/m2 per day Monday to Friday, plus Irinotecan 50 mg/m2 once weekly x 4 plus pelvic RT 45 Gy at 1.8 Gy per day and a boost of 5.4 Gy for T3 and 9 Gy for T4 cancers (Arm 2). Surgery was performed 4 to 10 weeks later. All eligible patients (n=103) are included in this analysis; excluded were 2 patients who were ineligible and 1 patient withdrew consent. 98 of 103 patients (95%) underwent resection . 4 patients did not undergo surgery for either disease progression or patient refusal and 1 patient died during induction chemotherapy. The median time of follow-up is 6.4 years in Arm 1 and 7.0 years in Arm 2. The pCR rate was 30% in Arm 1 and 26% in Arm 2. Loco-regional recurrence was 16% in Arm 1 and 17% in Arm 2. Five-year survival was 61% and 75% and Disease Specific Survival was 78% and 85% for Arm1 and Arm 2 respectively. Five second primaries occurred in patients on Arm 1, and one second primary occurred in Arm 2. High rate of Disease Specific Survival was seen in each arm. Overall survival appears effected by the development of unrelated second cancers. The high pCR rates with 5-FU and higher dose radiation in T4 cancers provides opportunity for increased R0 resections and improved survival.
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DOI：
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发表时间：
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影响因子：
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