Post-chemoradiation intraoperative electron-beam radiation therapy boost in resected locally advanced rectal cancer: Long-term results focused on topographic pattern of locoregional relapse |
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| Authors: | Claudio V Sole Felipe A Calvo Javier Serrano Emilio del Valle Marcos Rodriguez Alberto Muñoz-Calero Fernando Turégano Jose Luis García-Sabrido Pilar Garcia-Alfonso Isabel Peligros Sofia Rivera Eric Deutsch Emilio Alvarez |
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| Institution: | 1. Department of Radiation Oncology, Instituto de Radiomedicina, Santiago, Chile;2. Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France;3. Department of Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain;4. School of Medicine, Complutense University, Madrid, Spain;5. Service of Radiation Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain;6. Department of Surgery, Hospital General Universitario Gregorio Marañón, Madrid, Spain;g Service of Medical Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain;h Department of Pathology, Hospital General Universitario Gregorio Marañón, Madrid, Spain;i Instituto de Investigacion Sanitaria, Hospital General Universitario Gregorio Marañón, Madrid, Spain;j Molecular Radiotherapy Laboratory INSERM1030, Gustave Roussy Cancer Campus, Villejuif, France;k School of Medicine, Paris-Sud University, Villejuif, France |
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| Abstract: | BackgroundPatients with locally advanced rectal cancer (LARC) have a dismal prognosis. We investigated outcomes and risk factors for locoregional recurrence (LRR) in patients treated with preoperative chemoradiotherapy (CRT), surgery and IOERT.MethodsA total of 335 patients with LARC ?cT3 93% and/or cN+ 69%) were studied. In multivariate analyses, risk factors for LRR, IFLR and OFLR were assessed.ResultsMedian follow-up was 72.6 months (range, 4–205). In multivariate analysis distal margin distance ?10 mm HR 2.46, p = 0.03], R1 resection HR 5.06, p = 0.02], tumor regression grade 1–2 HR 2.63, p = 0.05] and tumor grade 3 HR 7.79, p < 0.001] were associated with an increased risk of LRR. A risk model was generated to determine a prognostic index for individual patients with LARC.ConclusionsOverall results after multimodality treatment of LARC are promising. Classification of risk factors for LRR has contributed to propose a prognostic index that could allow us to guide risk-adapted tailored treatment. |
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| Keywords: | Locally advanced rectal cancer Intraoperative radiotherapy Surgery External beam radiation therapy |
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