Preoperative hyperfractionated accelerated radiotherapy (HART) in locally advanced rectal cancer (LARC) immediately followed by surgery. A prospective phase II trial
Preoperative hyperfractionated accelerated radiotherapy (HART) in locally advanced rectal cancer (LARC) immediately followed by surgery. A prospective phase II trial
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DOI：
10.1016/j.radonc.2006.02.004
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发表时间：
2006-04-01
影响因子：
5.7
通讯作者：
Bouzourene, Hanifa
中科院分区：
文献类型：
--
作者：
Coucke, Philippe A.;Notter, Markus;Bouzourene, Hanifa
背景和目的：我们旨在报道一项关于局部晚期可切除直肠癌(LARC)术前超分割加速放射治疗计划(HART)的11期试验的局部控制情况。患者和方法：这是一项针对UICC II期和III期直肠癌患者的前瞻性试验。患者接受总剂量41.6Gy2.5周，每次1.6Gy1次，每日2次，间隔6h。照射结束后1周内进行手术。结果：279例患者进入，其中250例可完全评估，中位随访时间为39个月。5年精算局部控制率为91.7%。总生存率(OS)为59.6%。疾病无复发(FDR)率为71.5%。结论：尽管II-III期LARC主要位于直肠下段(中位距离=5厘米)，但5年的精算LC为91.7%。失败的模式以远处转移为主，强化治疗显然需要系统性的方法。(C)2006爱思唯尔爱尔兰有限公司。保留所有权利。
Background and purpose: We aim to report on local control in a phase 11 trial on preoperative hyperfractionated and accelerated radiotherapy schedule (HART) in locally advanced resectable rectal cancer (LARC). This fractionation schedule was designed to keep the overall treatment time (OTT) as short as possible.Patients and methods: This is a prospective trial on patients with UICC stages II and III rectal cancer. The patients were submitted to a total dose of 41.6 Gy, delivered in 2.5 weeks at 1.6 Gy per fraction twice a day with a 6-h interfraction interval. Surgery was performed within 1 week after the end of irradiation. Adjuvant chemotherapy was delivered in a subset of patients.Results: Two hundred and seventy nine patients were entered and 250 are fully assessable, with a median follow-up of 39 months. The 5-years actuarial local control (LC) rate is 91.7%. The overall survival (OS) is 59.6%. The freedom from disease relapse (FDR) is 71.5%. Downstaging was observed in 38% of the tumors.Conclusion: The actuarial LC at 5 years is 91.7%, although we are dealing with stages II-III LARC, mainly located in the lower rectum (median distance = 5 cm). The pattern of failure is dominated by distant metastases and treatment intensification will obviously require a systemic approach. (c) 2006 Elsevier Ireland Ltd. All rights reserved.