Impact of total neoadjuvant therapy consisting of consolidation chemotherapy on locally advanced rectal cancer survival View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2022-06-18

AUTHORS

Haoyu Zhang, Ganbin Li, Ke Cao, Zhiwei Zhai, Guanghui Wei, Hao Qu, Zhenjun Wang, Jiagang Han

ABSTRACT

PurposeThe objective was to compare disease-free survival (DFS) and distant metastasis in patients with neoadjuvant chemoradiotherapy (NCRT) and total neoadjuvant therapy (TNT) for locally advanced rectal cancer.MethodsPatients with cT3-4N0M0 or cTxN1-2M0 rectal cancer were included in this retrospective study. Patients who received NCRT (radiotherapy with concurrent capecitabine) or TNT (radiotherapy with two concurrent cycles of capecitabine and oxaliplatin (CAPOX) followed by another two cycles of CAPOX) during January 2011 and November 2016 at Beijing Chaoyang Hospital, Capital Medical University were included. All patients had received radical surgery. Adverse events, pathological response and survival outcomes in the two groups were compared.ResultsOne hundred eighty-two patients were enrolled, 120 in the TNT and 62 in the NCRT groups. No significant between-group differences in neoadjuvant therapy-associated adverse events or surgical complications were found. TNT achieved a higher pathological complete response (pCR) rate (25.8%) compared with NCRT (12.9%, P = 0.044). Patients in the TNT group had a higher 3-year DFS rate (82.8% versus 75.7%, P = 0.041) and lower distant metastasis rate (19.2% versus 33.1%, P = 0.049) than those in the NCRT group. Multivariate analysis showed that NCRT was an independent risk factor for DFS (95%CI 2.023–13.415, P = 0.001) and distant metastasis (95% CI 2.149–20.082, P = 0.001).ConclusionWith similar adverse events and a higher pCR rate when compared with NCRT, TNT might be considered as a safe and effective therapeutic strategy to improve prognosis in patients with locally advanced rectal cancer. More... »

PAGES

1657-1668

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http://scigraph.springernature.com/pub.10.1007/s00384-022-04179-7

DOI

http://dx.doi.org/10.1007/s00384-022-04179-7

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https://app.dimensions.ai/details/publication/pub.1148785393

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/35716183


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