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Role of pelvic radiotherapy for locally advanced rectal cancer and synchronous unresectable distant metastases |
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| Institution: | 1. Department of Radiation Oncology, Fudan University Shanghai Cancer Centre, Shanghai, China;2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China;3. Department of Radiation Oncology, Lihuili Hospital, Ningbo Medical Centre, 315041 Ningbo, China;4. Department of Colorectal Surgery, Fudan University Shanghai Cancer Centre, Shanghai, China;1. Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO;2. Department of Radiology, University of Colorado School of Medicine, Aurora, CO;3. Department of Pathology, University of Colorado School of Medicine, Aurora, CO;1. Department of Surgery, National Defense Medical College, 3-2, Namiki, Tokorozawa, Saitama 359-8513, Japan;2. Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan;3. Department of Laboratory Medicine, National Defense Medical College, Tokorozawa, Japan;4. Laboratory for Mathematics, National Defense Medical College, Tokorozawa, Japan;5. Laboratory for Statistical Analysis, Center for Genomic Medicine, RIKEN, Yokohama, Japan;1. Universidade Estadual de Campinas, UNICAMP, Campinas, SP, Brazil;2. Universidade Federal do Vale do São Francisco, UNIVASF, Petrolina, PE, Brazil;3. Universidade Estadual de Londrina, UEL, Londrina, PR, Brazil |
| Abstract: | PurposeTo evaluate the efficacy and safety of pelvic irradiation combined systematic chemotherapy in patients with locally advanced (cT3–T4 and/or cN+) rectal cancer and synchronous unresectable distant metastases.Patients and methodsA total of 76 eligible patients who received pelvic radiotherapy and concurrent capecitabine-based chemotherapy were retrospectively reviewed. Patients survival curves were constructed using the Kaplan-Meier method, and a multivariate analysis was performed to identify independent prognostic factors.ResultsMost of the adverse events were mild during the period of combined chemoradiotherapy. Twenty-two patients experienced resection of primary tumour and 16 patients underwent radical surgery of all lesions. Only five patients had pelvic progression during the follow-up period. The median progression-free survival and median overall survival were 13 and 30 months, respectively. Radical surgery of all lesions following chemoradiotherapy was found to be an independent prognostic factor according to multivariate analysis.ConclusionsPelvic irradiation combined with systematic chemotherapy in patients with locally advanced rectal cancer and synchronous unresectable distant metastases is effective and tolerable, both for pelvic and distant control. A curative resection following chemoradiotherapy was associated with prolonged survival. |
| Keywords: | Rectal cancer Metastatic Unresectable Pelvic radiotherapy Chemoradiotherapy Curative resection Cancer du rectum Métastatique Non résécable Radiothérapie pelvienne Chimioradiothérapie Résection curative |
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