Department of Abdominal Oncology(Luo Y,Wang WL,Han L,Dong HM,Wang G),Physical Technical Room(Wang ZHY,Hu YX),Department of Anus and Intestine(Wang ZJ),Cancer Hospital of Guizhou Medcial University and Guizhou Cancer Hospital,Guiyang 550004,China;Department of Anus and Intestine,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China(Zhang RY,Zhen YH)
Abstract： Objective To investigate the efficacy and safety of preoperative modified short-course chemoradiotherapy and conventionally fractionated chemoradiotherapy for rectal cancer. Methods A total of 60 patients with resectable rectal cancer were randomized into preoperative modified short-course chemoradiotherapy group (group A, 30 patients, 30 Gy in 10 fractions) and conventionally fractionated chemoradiotherapy group (group B, 30 patients, 45 Gy in 25 fractions), and surgery was performed at 2 weeks and 6-8 weeks after chemoradiotherapy, respectively. Results Group A and group B had pathologic downstaging rates of 30% and 67%(P=0.004), sphincter preservation rates of 53% and 68%(P=0.291), RO resection rates of 97% and 100%(P=0.236), 3-year overall survival rates of 83% and 88%(P=0.717), 3-year locoregional recurrence rates of 10% and 7%(P=0.639), and 3-year distant metastasis rates of 27% and 30%(P=0.774). In these two groups, the patients with or without the downstaging phenomenon had a 3-year overall survival rate of 97% or 74%(P=0.016). The incidence rates of grade 1-3 radiodermatitis, grade 2 radiation enteritis, and grade 2 leucopenia, anastomotic leak, and delayed wound healing were similar between the two groups (P=0.092-0.717). Conclusions Both preoperative modified short-course chemoradiotherapy and conventionally fractionated chemoradiotherapy can be used as the regimen of preoperative neoadjuvant chemoradiotherapy in patients with resectable rectal cancer, and preoperative modified short-course chemoradiotherapy has a short treatment cycle, a short time of hospital stay, and a low cost, and is easily accepted by patients.
Luo Yan,Wang Wenling,Han Lei et al. Different fractionation schedules of radiotherapy in preoperative concurrent chemoradiotherapy for rectal cancer:a clinical study[J]. Chinese Journal of Radiation Oncology, 2016, 25(5): 467-471.
[1]李晔雄,金晶.直肠癌术前同步放化疗临床治疗进展[J].中国医学前沿杂志,2010,2(2):5-7.DOI:10.3969/j.issn.1674-7372.2010.02.002. Li YX,Jin J.Preoperative clinical treatment of rectal cancer chemoradiation progress[J].Chin J Front Med Sci,2010,2(2):5-7.DOI:10.3969/j.issn.1674-7372.2010.02.002. [2]Bosset JF,Collette L,Calais G,et al. Chemotherapy with preoperative radiotherapy in rectal cancer[J].N Engl J Med,2006,355(11):1114-1123.DOI:10.1056/NEJMoa060829. [3]Sauer R,Becker H,Hohenberger W,et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer[J].N Engl J Med,2004,351(17):1731-1740.DOI:10.1056/NEJMoa040694. [4]Roh MS,Colangelo LH,O′Connell MJ,et al. Preoperative multimodality therapy improves disease-free survival in patients with carcinoma of the rectum:NSABP R-03[J].J Clin Oncol,2009,27(31):5124-5130.DOI:10.1200/JCO.2009.22.0467. [5]Kim JC,Yu CS,Lim SB,et al. Abdominoperineal resection and low anterior resection:comparison of long-term oncologic outcome in matched patients with lower rectal cancer[J].Int J Colorectal Dis,2013,28(4):493-501.DOI:10.1007/s00384-012-1590-8. [6]Colorectal Cancer Collaborative Group. Adjuvant radiotherapy for rectal cancer:a systematic overview of 8507 patients from 22 randomised trials[J].Lancet,2001,358(9290):1291-1304.DOI:10.1016/S0140-6736(01)06409-1. [7]Roels S,Duthoy W,Haustermans K,et al. Definition and delineation of the clinical target volume for rectal cancer[J].Int Radiat Oncol Biol Phys,2006,65(4):1129-1142.DOI:10.1016/j.ijrobp.2006.02.050. [8]MacFarlane JK,Ryall RDH,Heald RJ.Mesorectal excision for rectal Cancer[J].Lancet,1993,341(8843):457-460.DOI:10.1016/0140-6736(93)90207-W. [9]Roh MS,Yothers GA,O’Connell MJ,et al. The impact of capecitabine and oxaliplatin in the preoperative multimodality treatment in patients with carcinoma of the rectum:NSABP R-04[J].J Clin Oncol,2011,29(15):3503. [10]Pach R,Kulig J,Richter P,et al. Randomized clinical trial on preoperative radiotherapy 25 Gy in rectal cancer-treatment results at 5-year follow-up[J].Langenbecks Arch Surg,2012,397(5):801-807.DOI:10.1007/s00423-011-0890-8.
2016, Vol. 25 
