Post-chemoradiation intraoperative electron-beam radiation therapy boost in resected locally advanced rectal cancer: long-term results focused on topographic pattern of locoregional relapse.

Abstract

BACKGROUND:

Patients with locally advanced rectal cancer (LARC) have a dismal prognosis. We investigated outcomes and risk factors for locoregional recurrence (LRR) in patients treated with preoperative chemoradiotherapy (CRT), surgery and IOERT.

METHODS:

A total of 335 patients with LARC [⩾cT3 93% and/or cN+ 69%) were studied. In multivariate analyses, risk factors for LRR, IFLR and OFLR were assessed.

RESULTS:

Median follow-up was 72.6 months (range, 4-205). In multivariate analysis distal margin distance ⩽10 mm [HR 2.46, p = 0.03], R1 resection [HR 5.06, p = 0.02], tumor regression grade 1-2 [HR 2.63, p = 0.05] and tumor grade 3 [HR 7.79, p < 0.001] were associated with an increased risk of LRR. A risk model was generated to determine a prognostic index for individual patients with LARC.

CONCLUSIONS:

Overall results after multimodality treatment of LARC are promising. Classification of risk factors for LRR has contributed to propose a prognostic index that could allow us to guide risk-adapted tailored treatment.

• Authors: Claudio V Sole, Felipe A Calvo, Javier Serrano, Emilio Del Valle, Marcos Rodriguez, Alberto Muñoz-Calero, Fernando Turégano, Jose Luis García-Sabrido, Pilar Garcia-Alfonso, Isabel Peligros, Sofia Rivera, Eric Deutsch, Emilio Alvarez
• Journal: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology (Radiother Oncol) Vol. 112 Issue 1 Pg. 52-8 (Jul 2014) ISSN: 1879-0887 [Electronic] Ireland
• PMID: 24997989 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Organoplatinum Compounds
• Tegafur
• Leucovorin
• Fluorouracil

Topics

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Chemoradiotherapy (methods)
• Electrons
• Female
• Fluorouracil (administration & dosage, therapeutic use)
• Humans
• Intraoperative Care
• Leucovorin (therapeutic use)
• Male
• Middle Aged
• Neoadjuvant Therapy
• Neoplasm Recurrence, Local (pathology)
• Organoplatinum Compounds (therapeutic use)
• Prognosis
• Radiotherapy, Conformal (methods)
• Rectal Neoplasms (pathology, therapy)
• Tegafur (administration & dosage)