학술논문
Time to surgery and pathologic complete response after neoadjuvant chemoradiation in rectal cancer: A population study on 2094 patients
Document Type
article
Author
Gabriella Macchia; Maria Antonietta Gambacorta; Carlotta Masciocchi; Giuditta Chiloiro; Giovanna Mantello; Maika di Benedetto; Marco Lupattelli; Elisa Palazzari; Liliana Belgioia; Almalina Bacigalupo; Aldo Sainato; Sabrina Montrone; Lucia Turri; Angela Caroli; Antonino De Paoli; Fabio Matrone; Carlo Capirci; Giampaolo Montesi; Rita Marina Niespolo; Mattia Falchetto Osti; Luciana Caravatta; Alessandra Galardi; Domenico Genovesi; Maria Elena Rosetto; Caterina Boso; Piera Sciacero; Lucia Giaccherini; Salvatore Parisi; Antonella Fontana; Francesco Romeo Filippone; Vincenzo Picardi; Alessio Giuseppe Morganti; Vincenzo Valentini
Source
Clinical and Translational Radiation Oncology, Vol 4, Iss C, Pp 8-14 (2017)
Subject
Language
English
ISSN
2405-6308
Abstract
Background: To retrospectively evaluate the difference in terms of pathologic complete response (pCR) according to time elapsed between chemoradiation (CRT) and total mesorectal excision (TME) on a large unselected real-life dataset of locally advanced rectal cancer (LARC) patients. Methods: A multicentre retrospective cohort study of LARC patients from 21 Italian Radiotherapy Institutions was performed. Patients were stratified into 3 different time intervals from CRT. The 1st group included 300 patients who underwent TME within 6 weeks, the 2nd 1598 patients (TME within 7–12 weeks) and the 3rd 196 patients (TME within 13 or more weeks after CRT), respectively. Results: Data on 2094 LARC patients treated between 1997 and 2016 were considered suitable for analysis. Overall, 578 patients had stage II while 1516 had stage III histological proven invasive rectal adenocarcinoma. A CRT schedule of one agent (N = 1585) or 2-drugs (N = 509) was administered. Overall, pCR was 22.3% (N = 468 patients). The proportion of patients achieving pCR with respect to time interval was, as follows: 12.6% (1st group), 23% (2nd group) and 31.1% (3rd group) (p 5040 cGy (p = 0.002) and longer interval (p 13 weeks) from CRT to surgery improves the pathological response (pCR and pathologic partial response; pPR) in comparison to historic data. Furthermore, radiotherapy dose >5040 cGy and two drugs chemotherapy correlated with pPR rate.