Open Access

Efficacy of hypofractionated preoperative chemoradiotherapy in rectal cancer

  • Authors:
    • Ick Joon Cho
    • Jae-Uk Jeong
    • Taek-Keun Nam
    • Yong-Hyub Kim
    • Ju-Young Song
    • Mee Sun Yoon
    • Sung-Ja Ahn
    • Shin Haeng Cho
  • View Affiliations

  • Published online on: May 3, 2023     https://doi.org/10.3892/ol.2023.13849
  • Article Number: 263
  • Copyright: © Cho et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The efficacy and toxicity of hypofractionated preoperative chemoradiotherapy (HPCRT) combined with oral capecitabine was evaluated in patients with rectal cancer. HPCRT was delivered by intensity‑modulated radiotherapy of either 33 Gy to the whole pelvis or 35 Gy in 10 fractions to the primary tumor and 33 Gy to the surrounding pelvis. Surgery was performed 4‑8 weeks after HPCRT completion. Oral capecitabine was administered concurrently. A total of 76 patients were eligible for this study, and patient numbers in clinical stages I, II, III and IVA were 5, 29, 36 and 6, respectively. Tumor response, toxicity and survival were analyzed. A total of 9/76 patients (11.8%) achieved a pathological complete response. Sphincter preservation was achieved in 23/32 (71.9%) and 44/44 (100%) of patients with a distal extent from the anal verge of ≤5 and >5 cm, respectively. A total of 28/76 patients (36.8%) achieved tumor‑downstaging and 25/76 (32.9%) achieved nodal (N)‑downstaging. The 5‑year disease‑free survival (DFS) and overall survival rates were 76.5% and 90.6%, respectively. In the multivariate analysis for DFS, pathological N stage and lymphovascular space invasion were notable prognostic factors. A total of 6 patients in stage IVA underwent salvage treatments for lung or liver metastasis after HPCRT completion, and all 6 were alive at the last follow‑up. Only 4 patients experienced grade 3 postoperative complications. No grade 4 toxicities were observed. HPCRT of 33 or 35 Gy in 10 fractions showed similar results to those of long‑course fractionation. This fractionation scheme could be beneficial for patients with early stage disease, locally advanced rectal cancer, simultaneous distant metastasis requiring early intervention or for patients who wish to avoid multiple hospital visits.
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June-2023
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Spandidos Publications style
Cho IJ, Jeong J, Nam T, Kim Y, Song J, Yoon MS, Ahn S and Cho SH: Efficacy of hypofractionated preoperative chemoradiotherapy in rectal cancer. Oncol Lett 25: 263, 2023
APA
Cho, I.J., Jeong, J., Nam, T., Kim, Y., Song, J., Yoon, M.S. ... Cho, S.H. (2023). Efficacy of hypofractionated preoperative chemoradiotherapy in rectal cancer. Oncology Letters, 25, 263. https://doi.org/10.3892/ol.2023.13849
MLA
Cho, I. J., Jeong, J., Nam, T., Kim, Y., Song, J., Yoon, M. S., Ahn, S., Cho, S. H."Efficacy of hypofractionated preoperative chemoradiotherapy in rectal cancer". Oncology Letters 25.6 (2023): 263.
Chicago
Cho, I. J., Jeong, J., Nam, T., Kim, Y., Song, J., Yoon, M. S., Ahn, S., Cho, S. H."Efficacy of hypofractionated preoperative chemoradiotherapy in rectal cancer". Oncology Letters 25, no. 6 (2023): 263. https://doi.org/10.3892/ol.2023.13849