The outcomes of therapeutic decision in lower 3rd rectal cancer patients

Chien Hsin Chen, Po Li Wei, Mao Chih Hsieh, En Kwang Lin, Jeng Fong Chiou, Yen Jung Lu, Szu Yuan Wu

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

To investigate the outcomes of the selective neoadjuvant concurrent chemoradiotherapy (CCRT) in lower 3rd rectal cancer patients in different groups (with or without neoadjuvant CCRT), especially in survival rate, local recurrence rate, and sphincter preservation rate. From January 1999 to December 2012, 69 consecutive patients who had histologically proven adenocarcinoma of lower 3rd rectum, defined preoperatively as lower tumor margin within 7cm from the anal verge as measured by rigid sigmoidoscopy, received total mesorectum excision (TME). Our inclusion criteria of neoadjuvant CCRT are lower 3rd rectal cancer, stage II/III, and large (diameter >5cm or >1/2 of circumference). Neoadjuvant concurrent CCRT had begun to apply lower 3rd rectal cancer patients or not. The radiation techniques of neoadjuvant CCRT for lower 3rd rectal cancer patients were all conventional fraction intensity modulated radiotherapy (IMRT) and concurrent fluoropyrimidine chemotherapy. Five-year overall survival rate, disease-free survival rate, and local recurrence rate for lower 3rd rectal cancer patients in group I were 51%, 45%, and 25%, respectively. On the contrary, 5-year overall survival rate, disease-free survival rate, and local recurrence rate for lower rectal cancer patients in group II were 70%, 70%, and 3%, respectively. The 5-year sphincter sparing rate was increased from 38.2% to 100% after the beginning of neoadjuvant CCRT. Analyzing local recurrence, overall survival rate, diseasespecific survival rate, and sphincter sparing rate in group II were statistically significant superior to group I. Five-year overall survival rate, disease-free survival rate, and sphincter sparing rate for lower 3rd rectal cancer patients were improved after the addition of neoadjuvant CCRT. No unacceptable toxicity was noted after conventional fraction IMRT and concurrent fluoropyrimidine chemotherapy. Our study showed neoadjuvant CCRT could be valuable for lower 3rd rectal cancer patients.

Original languageEnglish
Article numbere4638
JournalMedicine (United States)
Volume95
Issue number37
DOIs
Publication statusPublished - 2016

Fingerprint

Rectal Neoplasms
Chemoradiotherapy
Survival Rate
Disease-Free Survival
Recurrence
Intensity-Modulated Radiotherapy
Therapeutics
Sigmoidoscopy
Drug Therapy
Rectum
Adenocarcinoma
Radiation

Keywords

  • CCRT
  • Low 3rd
  • Neoadjuvant
  • Rectal cancer

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The outcomes of therapeutic decision in lower 3rd rectal cancer patients. / Chen, Chien Hsin; Wei, Po Li; Hsieh, Mao Chih; Lin, En Kwang; Chiou, Jeng Fong; Lu, Yen Jung; Wu, Szu Yuan.

In: Medicine (United States), Vol. 95, No. 37, e4638, 2016.

Research output: Contribution to journalArticle

Chen, Chien Hsin ; Wei, Po Li ; Hsieh, Mao Chih ; Lin, En Kwang ; Chiou, Jeng Fong ; Lu, Yen Jung ; Wu, Szu Yuan. / The outcomes of therapeutic decision in lower 3rd rectal cancer patients. In: Medicine (United States). 2016 ; Vol. 95, No. 37.
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AB - To investigate the outcomes of the selective neoadjuvant concurrent chemoradiotherapy (CCRT) in lower 3rd rectal cancer patients in different groups (with or without neoadjuvant CCRT), especially in survival rate, local recurrence rate, and sphincter preservation rate. From January 1999 to December 2012, 69 consecutive patients who had histologically proven adenocarcinoma of lower 3rd rectum, defined preoperatively as lower tumor margin within 7cm from the anal verge as measured by rigid sigmoidoscopy, received total mesorectum excision (TME). Our inclusion criteria of neoadjuvant CCRT are lower 3rd rectal cancer, stage II/III, and large (diameter >5cm or >1/2 of circumference). Neoadjuvant concurrent CCRT had begun to apply lower 3rd rectal cancer patients or not. The radiation techniques of neoadjuvant CCRT for lower 3rd rectal cancer patients were all conventional fraction intensity modulated radiotherapy (IMRT) and concurrent fluoropyrimidine chemotherapy. Five-year overall survival rate, disease-free survival rate, and local recurrence rate for lower 3rd rectal cancer patients in group I were 51%, 45%, and 25%, respectively. On the contrary, 5-year overall survival rate, disease-free survival rate, and local recurrence rate for lower rectal cancer patients in group II were 70%, 70%, and 3%, respectively. The 5-year sphincter sparing rate was increased from 38.2% to 100% after the beginning of neoadjuvant CCRT. Analyzing local recurrence, overall survival rate, diseasespecific survival rate, and sphincter sparing rate in group II were statistically significant superior to group I. Five-year overall survival rate, disease-free survival rate, and sphincter sparing rate for lower 3rd rectal cancer patients were improved after the addition of neoadjuvant CCRT. No unacceptable toxicity was noted after conventional fraction IMRT and concurrent fluoropyrimidine chemotherapy. Our study showed neoadjuvant CCRT could be valuable for lower 3rd rectal cancer patients.

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