Long-term treatment outcomes in patients with low rectal cancer
https://doi.org/10.17650/2220-3478-2019-9-1-26-33
Abstract
Objective: to assess the effect of preoperative treatment option on the number of sphincter-preserving operations (SPO) in patients with low rectal cancer.
Materials and methods. The patients with low rectal cancer (0—6 cm from anocutaneous line) were randomized into 3 groups: in the 1st control group surgery was performed in 0—3 days after completion of short-course radiotherapy (5 х 5 Gy). Patients in the 2nd control group received identical radiotherapy but the interval before surgery was extended to 42 ± 3 days. Patients in the study group received treatment identical to 2nd control group with 2 additional courses of monochemotherapy with capecitabine, starting on the first day of radiotherapy. The primary endpoint was the number of SPO. Complete pathomorphologic response rate, overall survival, tumor-specific survival and event-free 5-year survival were also assessed as secondary endpoints.
Results. Data on 129 patients was analyzed: 46 in the 1st control group, 43 in the 2nd control group, 40 in the study group. The proportion of SPO was 41,3 ± 7,3 % in the 1st group, 69,7 ± 7,0 % and 77,5 ± 6,6 % in the 2nd group and study group, respectively. Complete histological response was achieved in 15 % of patients in study group, comparing to 14,3 % of patients in the 2nd group. Overall 5-year survival in this study was estimated to be 77,8 ± 4,5%, tumor-specific survival — 89,7 ± 3,7 %, event-free survival — 90,1 ± 2,9 %, with no significant differences between groups.
Conclusion. Short-course radiotherapy (5 х 5 Gy) with 6-week interval before surgery resulted in increase of SPO rate with no affect on oncologic outcome.
About the Authors
A. A. Yudin
N.N. Aleksandrov Republican Research and Practical Center for Oncology and Medical Radiology
Belarus
Belarus
Lesnoy Agrotown, Minsk District 223040
V. T. Kokhnyuk
N.N. Aleksandrov Republican Research and Practical Center for Oncology and Medical Radiology
Belarus
Belarus
Lesnoy Agrotown, Minsk District 223040
G. I. Коlyadich
N.N. Aleksandrov Republican Research and Practical Center for Oncology and Medical Radiology
Belarus
Belarus
Lesnoy Agrotown, Minsk District 223040
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