Neoadjuvant chemoradiotherapy for patients with unresectable radically locally advanced colon cancer: a potential improvement to overall survival and decrease to multivisceral resection

被引:15
|
作者
Yuan, Yan [1 ,2 ]
Xiao, Wei-Wei [1 ,2 ]
Xie, Wei-Hao [1 ,2 ]
Cai, Pei-Qiang [1 ,3 ,4 ]
Wang, Qiao-Xuan [1 ,2 ]
Chang, Hui [1 ,2 ]
Chen, Bao-Qing [1 ,2 ]
Zhou, Wen-Hao [1 ,5 ]
Zeng, Zhi-Fan [1 ,2 ]
Wu, Xiao-Jun [1 ,5 ]
Liu, Qing [1 ,6 ]
Li, Li-Ren [1 ,5 ]
Zhang, Rong [1 ,7 ]
Gao, Yuan-Hong [1 ,2 ]
机构
[1] Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China, Guangzhou, Peoples R China
[2] Sun Yat Sen Univ, Dept Radiat Oncol, Canc Ctr, Guangzhou, Peoples R China
[3] Sun Yat Sen Univ, Canc Ctr, Dept Med Imaging, Guangzhou, Peoples R China
[4] Sun Yat Sen Univ, Canc Ctr, Dept Intervent Radiol, Guangzhou, Peoples R China
[5] Sun Yat Sen Univ, Ctr Canc, Dept Colorectal Surg, Guangzhou, Peoples R China
[6] Sun Yat Sen Univ, Ctr Canc, Dept Epidemiol & Biostat, Guangzhou, Peoples R China
[7] Sun Yat Sen Univ, Ctr Canc, Dept Endoscopy & Laser, Guangzhou, Peoples R China
基金
中国国家自然科学基金;
关键词
Locally advanced colon cancer; Neoadjuvant chemoradiotherapy; Organ preservation; Pathological complete response; ADVANCED RECTAL-CANCER; COLORECTAL-CANCER; CHEMOTHERAPY; SURGERY;
D O I
10.1186/s12885-021-07894-6
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundThe management of unresectable locally advanced colon cancer (LACC) remains controversial, as resection is not feasible. The goal of this study was to evaluate the treatment outcomes and toxicity of neoadjuvant chemoradiotherapy (NACRT) followed with surgery and adjuvant chemotherapy in patients with unresectable radically LACC.MethodsWe included patients who were diagnosed at our institution, 2010-2018. The neoadjuvant regimen consisted of radiotherapy and capecitabine/ 5-fluorouracil-based chemotherapy.ResultsOne hundred patients were identified. The median follow-up time was 32months. The R0 resection rate, adjusted nonmultivisceral resection rate and bladder preservation rate were 83.0, 43.0 and 83.3%, respectively. The pCR and clinical-downstaging rates were 18, and 81.0%%, respectively. The 3-year PFS and OS rates for all patients were 68.6 and 82.1%, respectively. Seventeen patients developed grade 3-4 myelosuppression, which was the most common adverse event observed after NACRT. Tumor perforation occurred in 3 patients during NACRT. The incidence of grade 3-4 surgery-related complications was 7.0%. Postoperative anastomotic leakage was observed in 3 patients.ConclusionsNACRT followed by surgery was feasible and safe for selected patients with LACC, and can be used as a conversion treatment to achieve satisfactory downstaging, long-term survival and quality of life, with acceptable toxicities.
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页数:13
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