open access

Vol 18, No 2 (2013)
Original research articles
Published online: 2013-03-01
Submitted: 2011-04-20
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Neoadjuvant oral infusional chemoradiotherapy on locally advanced rectal cancer: Prognostic factors

Sofia Conde, Margarida Borrego, Tânia Teixeira, Rubina Teixeira, Anabela Sá, Paula Soares
DOI: 10.1016/j.rpor.2012.07.010
·
Rep Pract Oncol Radiother 2013;18(2):67-75.

open access

Vol 18, No 2 (2013)
Original research articles
Published online: 2013-03-01
Submitted: 2011-04-20

Abstract

Aim

To evaluate the prognostic factors and impact on survival of neoadjuvant oral and infusional chemoradiotherapy in patients with locally advanced rectal cancer.

Background

There is still no definitive consensus about the prognostic factors and the impact of neoadjuvant chemoradiotherapy on survival. Some studies have pointed to an improvement in overall survival (OS) and progression-free survival (PFS) in patients with tumor downstaging (TD) and nodal downstaging (ND).

Materials and methods

A set of 159 patients with LARC were treated preoperatively. Group A – 112 patients underwent concomitant oral chemoradiotherapy: capecitabine or UFT[[ce:hsp sp="0.25"/]]+[[ce:hsp sp="0.25"/]]folinic acid. Group B – 47 patients submitted to concomitant chemoradiation with 5-FU in continuous infusion. 63.6% of patients were submitted to adjuvant chemotherapy.

Results

Group A: pathologic complete response (pCR) – 18.7%; TD – 55.1%; ND – 76%; loco-regional response – 74.8%. Group B: pCR – 11.4%; TD – 50%; ND – 55.8%; LRR – 54.5%. The loco-regional control was 95.6%. There was no difference in survival between both groups. Those with loco-regional response had better PFS.

Conclusions

Tumor and nodal downstaging, loco-regional response and a normal CEA level turned out to be important prognostic factors in locally advanced rectal cancer. Nodal downstaging and loco-regional response were higher in Group A. Those with tumor downstaging and loco-regional response from Group A had better OS. Adjuvant chemotherapy had no impact on survival except in those patients with loco-regional response who achieved a higher PFS.

Abstract

Aim

To evaluate the prognostic factors and impact on survival of neoadjuvant oral and infusional chemoradiotherapy in patients with locally advanced rectal cancer.

Background

There is still no definitive consensus about the prognostic factors and the impact of neoadjuvant chemoradiotherapy on survival. Some studies have pointed to an improvement in overall survival (OS) and progression-free survival (PFS) in patients with tumor downstaging (TD) and nodal downstaging (ND).

Materials and methods

A set of 159 patients with LARC were treated preoperatively. Group A – 112 patients underwent concomitant oral chemoradiotherapy: capecitabine or UFT[[ce:hsp sp="0.25"/]]+[[ce:hsp sp="0.25"/]]folinic acid. Group B – 47 patients submitted to concomitant chemoradiation with 5-FU in continuous infusion. 63.6% of patients were submitted to adjuvant chemotherapy.

Results

Group A: pathologic complete response (pCR) – 18.7%; TD – 55.1%; ND – 76%; loco-regional response – 74.8%. Group B: pCR – 11.4%; TD – 50%; ND – 55.8%; LRR – 54.5%. The loco-regional control was 95.6%. There was no difference in survival between both groups. Those with loco-regional response had better PFS.

Conclusions

Tumor and nodal downstaging, loco-regional response and a normal CEA level turned out to be important prognostic factors in locally advanced rectal cancer. Nodal downstaging and loco-regional response were higher in Group A. Those with tumor downstaging and loco-regional response from Group A had better OS. Adjuvant chemotherapy had no impact on survival except in those patients with loco-regional response who achieved a higher PFS.

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Keywords

Rectal cancer; Neoadjuvant oral chemoradiotherapy; Neoadjuvant infusional chemoradiotherapy; Prognostic factors; Adjuvant chemotherapy

About this article
Title

Neoadjuvant oral infusional chemoradiotherapy on locally advanced rectal cancer: Prognostic factors

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 18, No 2 (2013)

Pages

67-75

Published online

2013-03-01

DOI

10.1016/j.rpor.2012.07.010

Bibliographic record

Rep Pract Oncol Radiother 2013;18(2):67-75.

Keywords

Rectal cancer
Neoadjuvant oral chemoradiotherapy
Neoadjuvant infusional chemoradiotherapy
Prognostic factors
Adjuvant chemotherapy

Authors

Sofia Conde
Margarida Borrego
Tânia Teixeira
Rubina Teixeira
Anabela Sá
Paula Soares

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