Total Neoadjuvant Therapy in Rectal Cancer: Multi-center Comparison of Induction Chemotherapy and Long-Course Chemoradiation Versus Short-Course Radiation and Consolidative Chemotherapy

被引：10

作者：

Moyer, Amber M. ^{[1
]}

Vogel, Jon D. ^{[1
]}

Lai, Samuel H. ^{[1
]}

Kim, Hyun ^{[2
]}

Chin, Re-, I ^{[2
]}

Moskalenko, Marina ^{[1
]}

Olsen, Jeffrey R. ^{[1
]}

Birnbaum, Elisa H. ^{[1
]}

Silviera, Matthew L. ^{[2
]}

Mutch, Matthew G. ^{[2
]}

Chapman, Brandon C. ^{[1
]}

机构：

[1] Univ Colorado, Dept Surg, Denver Sch Med, 12631 E 17Th Ave,C313, Aurora, CO 80045 USA

[2] Washington Univ, Sch Med, Dept Surg, St Louis, MO 63110 USA

来源：

JOURNAL OF GASTROINTESTINAL SURGERY | 2023年 / 27卷 / 05期

关键词：

Rectal cancer; Total neoadjuvant therapy; Complete response; TOTAL MESORECTAL EXCISION; COLORECTAL SURGERY; FOLLOW-UP; RADIOTHERAPY; RESECTION; CHEMORADIOTHERAPY; OUTCOMES; TRIAL; TME;

D O I：

10.1007/s11605-023-05601-3

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

BackgroundTotal neoadjuvant therapy for locally advanced rectal cancer may include induction chemotherapy and chemoradiation or short-course radiotherapy and consolidative chemotherapy.MethodsPatients with clinical stage 2 or 3 rectal cancer who received induction chemotherapy followed by long-course chemoradiation at the University of Colorado (2016-2020) or short-course radiotherapy followed by consolidative chemotherapy at Washington University (2017-2020) were assessed.ResultsEighty-four patients received induction chemotherapy and chemoradiation and 83 received short-course radiotherapy and consolidative chemotherapy. Among patients with complete re-staging evaluation, clinical complete response rates were similar, 49% (18/37) and 53% (44/83), respectively (p = 0.659). In the induction chemotherapy and chemoradiation group, 80% (n = 67) underwent surgery and 28% (n = 19) achieved a pathologic complete response. In the short-course radiotherapy and consolidative chemotherapy group, 44 (53%) patients underwent surgery and 11% (n = 5) had a pathologic complete response. Overall, a complete response was observed in 43% (n = 36) of patients who received induction chemotherapy and chemoradiation compared to 53% (n = 44) who received short-course radiotherapy and consolidative chemotherapy (p = 0.189). Perioperative outcomes were similar in patients who received induction chemotherapy and chemoradiation compared to short-course radiotherapy and consolidative chemotherapy: intraoperative complications (2% vs 7%), complete mesorectal specimen (85% vs 84%), anastomotic leak (9% vs 7%), organ/space infection (9% vs 5%), readmission (19% vs 21%), and reoperation (8% vs 9%), respectively (all p > 0.05).ConclusionsIn patients with clinical stage 2 or 3 rectal cancer, total neoadjuvant therapy with either induction chemotherapy and chemoradiation or short-course radiotherapy followed by consolidative chemotherapy were associated with similar perioperative morbidity and complete response rates.

引用

页码：980 / 989

页数：10

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