Sequential Boost in Neoadjuvant Irradiation for T3N0-1 Rectal Cancer: Long-Term Results from a Single-Center Experience
Purpose To evaluate the influence of radiation dose on tumor regression grade (TRG) and sphincter preservation rate in a series of cT3N0-1 rectal cancer patients treated with neoadjuvant chemoradiotherapy (CT-RT) with or without a sequential radiation boost. Materials and methods Between May 2002 an...
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| Veröffentlicht in: | Tumori 2016-05, Vol.102 (3), p.316-322 |
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| creator | Mazzola, Rosario Ferrera, Giuseppe Cucchiara, Teresa Figlia, Vanessa Gueci, Marina Sciumè, Francesco Di Paola, Gioacchino Scibetta, Nunzia Lo Casto, Antonio Pappalardo, Maria Pia Lagalla, Roberto Alongi, Filippo |
| description | Purpose
To evaluate the influence of radiation dose on tumor regression grade (TRG) and sphincter preservation rate in a series of cT3N0-1 rectal cancer patients treated with neoadjuvant chemoradiotherapy (CT-RT) with or without a sequential radiation boost.
Materials and methods
Between May 2002 and September 2013, 116 cases were eligible for retrospective evaluation. Radiotherapy was delivered for a total dose of 45 Gy (no boost arm) or 50.4 Gy (boost arm). TRG was evaluated with the Dworak scale.
Results
Median follow-up was 62 months (range, 12-138 months). The 5-year overall survival and local control rates were 72% and 93%, respectively. Fifty-five patients (47%) were treated with a sequential radiation boost and 61 (53%) without a boost. Eighty patients (72%) presented T3N0 disease and 32 (28%) T3N1 disease. Concomitant capecitabine was administered in 92 cases (79%) and intravenous 5-fluorouracil in 24 cases (21%). Sphincter preservation was performed in 82% of patients in the boost arm and 66% in the no-boost arm. A higher TRG was related to a longer interval between neoadjuvant treatment and surgery (p |
| doi_str_mv | 10.5301/tj.5000481 |
| format | Article |
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To evaluate the influence of radiation dose on tumor regression grade (TRG) and sphincter preservation rate in a series of cT3N0-1 rectal cancer patients treated with neoadjuvant chemoradiotherapy (CT-RT) with or without a sequential radiation boost.
Materials and methods
Between May 2002 and September 2013, 116 cases were eligible for retrospective evaluation. Radiotherapy was delivered for a total dose of 45 Gy (no boost arm) or 50.4 Gy (boost arm). TRG was evaluated with the Dworak scale.
Results
Median follow-up was 62 months (range, 12-138 months). The 5-year overall survival and local control rates were 72% and 93%, respectively. Fifty-five patients (47%) were treated with a sequential radiation boost and 61 (53%) without a boost. Eighty patients (72%) presented T3N0 disease and 32 (28%) T3N1 disease. Concomitant capecitabine was administered in 92 cases (79%) and intravenous 5-fluorouracil in 24 cases (21%). Sphincter preservation was performed in 82% of patients in the boost arm and 66% in the no-boost arm. A higher TRG was related to a longer interval between neoadjuvant treatment and surgery (p<0.001). The probability of a TRG ≥2 was 2.5 times higher in the boost arm. A gain in local control, estimated at 4% during the first 3 years after CT-RT, favored the boost arm.
Conclusions
The long-term results from our single-center experience confirm literature data on the role of a sequential boost in tumor response after neoadjuvant CT-RT in a series of cT3N0-1 rectal cancer patients.</description><identifier>ISSN: 0300-8916</identifier><identifier>EISSN: 2038-2529</identifier><identifier>DOI: 10.5301/tj.5000481</identifier><identifier>PMID: 27002948</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adenocarcinoma - drug therapy ; Adenocarcinoma - pathology ; Adenocarcinoma - radiotherapy ; Adenocarcinoma - surgery ; Adult ; Aged ; Anal Canal ; Antineoplastic Agents - therapeutic use ; Capecitabine - administration & dosage ; Chemoradiotherapy ; Digestive System Surgical Procedures - methods ; Female ; Fluorouracil - administration & dosage ; Follow-Up Studies ; Gastrointestinal Tract - radiation effects ; Humans ; Ileostomy ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoadjuvant Therapy - methods ; Neoplasm Staging ; Organ Sparing Treatments ; Radiotherapy Dosage ; Radiotherapy, Adjuvant - adverse effects ; Rectal Neoplasms - drug therapy ; Rectal Neoplasms - pathology ; Rectal Neoplasms - radiotherapy ; Rectal Neoplasms - surgery ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Urogenital System - radiation effects</subject><ispartof>Tumori, 2016-05, Vol.102 (3), p.316-322</ispartof><rights>2016 SAGE Publications</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c319t-54c968eb7d6edd0ae2ddc940936ee5712968adf8c7dea96e8df802c6bb45c9693</citedby><cites>FETCH-LOGICAL-c319t-54c968eb7d6edd0ae2ddc940936ee5712968adf8c7dea96e8df802c6bb45c9693</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.5301/tj.5000481$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.5301/tj.5000481$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>315,781,785,21824,27929,27930,43626,43627</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27002948$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mazzola, Rosario</creatorcontrib><creatorcontrib>Ferrera, Giuseppe</creatorcontrib><creatorcontrib>Cucchiara, Teresa</creatorcontrib><creatorcontrib>Figlia, Vanessa</creatorcontrib><creatorcontrib>Gueci, Marina</creatorcontrib><creatorcontrib>Sciumè, Francesco</creatorcontrib><creatorcontrib>Di Paola, Gioacchino</creatorcontrib><creatorcontrib>Scibetta, Nunzia</creatorcontrib><creatorcontrib>Lo Casto, Antonio</creatorcontrib><creatorcontrib>Pappalardo, Maria Pia</creatorcontrib><creatorcontrib>Lagalla, Roberto</creatorcontrib><creatorcontrib>Alongi, Filippo</creatorcontrib><title>Sequential Boost in Neoadjuvant Irradiation for T3N0-1 Rectal Cancer: Long-Term Results from a Single-Center Experience</title><title>Tumori</title><addtitle>Tumori</addtitle><description>Purpose
To evaluate the influence of radiation dose on tumor regression grade (TRG) and sphincter preservation rate in a series of cT3N0-1 rectal cancer patients treated with neoadjuvant chemoradiotherapy (CT-RT) with or without a sequential radiation boost.
Materials and methods
Between May 2002 and September 2013, 116 cases were eligible for retrospective evaluation. Radiotherapy was delivered for a total dose of 45 Gy (no boost arm) or 50.4 Gy (boost arm). TRG was evaluated with the Dworak scale.
Results
Median follow-up was 62 months (range, 12-138 months). The 5-year overall survival and local control rates were 72% and 93%, respectively. Fifty-five patients (47%) were treated with a sequential radiation boost and 61 (53%) without a boost. Eighty patients (72%) presented T3N0 disease and 32 (28%) T3N1 disease. Concomitant capecitabine was administered in 92 cases (79%) and intravenous 5-fluorouracil in 24 cases (21%). Sphincter preservation was performed in 82% of patients in the boost arm and 66% in the no-boost arm. A higher TRG was related to a longer interval between neoadjuvant treatment and surgery (p<0.001). The probability of a TRG ≥2 was 2.5 times higher in the boost arm. A gain in local control, estimated at 4% during the first 3 years after CT-RT, favored the boost arm.
Conclusions
The long-term results from our single-center experience confirm literature data on the role of a sequential boost in tumor response after neoadjuvant CT-RT in a series of cT3N0-1 rectal cancer patients.</description><subject>Adenocarcinoma - drug therapy</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - radiotherapy</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Anal Canal</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Capecitabine - administration & dosage</subject><subject>Chemoradiotherapy</subject><subject>Digestive System Surgical Procedures - methods</subject><subject>Female</subject><subject>Fluorouracil - administration & dosage</subject><subject>Follow-Up Studies</subject><subject>Gastrointestinal Tract - radiation effects</subject><subject>Humans</subject><subject>Ileostomy</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoadjuvant Therapy - methods</subject><subject>Neoplasm Staging</subject><subject>Organ Sparing Treatments</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy, Adjuvant - adverse effects</subject><subject>Rectal Neoplasms - drug therapy</subject><subject>Rectal Neoplasms - pathology</subject><subject>Rectal Neoplasms - radiotherapy</subject><subject>Rectal Neoplasms - surgery</subject><subject>Retrospective Studies</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Urogenital System - radiation effects</subject><issn>0300-8916</issn><issn>2038-2529</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkEFP3DAQha0KVJZtL_0BlW-gSoGxkzgxt3YFBWkFUnc5R157skqU2IvtFPj3NdotJ04z0nzvjd4j5BuDizIHdhn7ixIAipp9IjMOeZ3xkssjMoMcIKslEyfkNIQ-IcCF-ExOeAXAZVHPyPMKnya0sVMD_eVciLSz9B6dMv30V9lI77xXplOxc5a2ztN1fg8Zo39QxyRZKKvRX9Gls9tsjX5MhzANMdDWu5EquursdsBskV6gp9cvO_QdJs0XctyqIeDXw5yTx5vr9eI2Wz78vlv8XGY6ZzJmZaGlqHFTGYHGgEJujJYFyFwglhXj6apMW-vKoJIC67QD12KzKcqklPmcnO99d96loCE2Yxc0DoOy6KbQsEoWhZCpl4T-2KPauxA8ts3Od6Pyrw2D5q3oJvbNoegEfz_4TpsRzTv6v9kEnO2BoLbY9G7yNuX8yOofZs-FZA</recordid><startdate>20160501</startdate><enddate>20160501</enddate><creator>Mazzola, Rosario</creator><creator>Ferrera, Giuseppe</creator><creator>Cucchiara, Teresa</creator><creator>Figlia, Vanessa</creator><creator>Gueci, Marina</creator><creator>Sciumè, Francesco</creator><creator>Di Paola, Gioacchino</creator><creator>Scibetta, Nunzia</creator><creator>Lo Casto, Antonio</creator><creator>Pappalardo, Maria Pia</creator><creator>Lagalla, Roberto</creator><creator>Alongi, Filippo</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160501</creationdate><title>Sequential Boost in Neoadjuvant Irradiation for T3N0-1 Rectal Cancer: Long-Term Results from a Single-Center Experience</title><author>Mazzola, Rosario ; Ferrera, Giuseppe ; Cucchiara, Teresa ; Figlia, Vanessa ; Gueci, Marina ; Sciumè, Francesco ; Di Paola, Gioacchino ; Scibetta, Nunzia ; Lo Casto, Antonio ; Pappalardo, Maria Pia ; Lagalla, Roberto ; Alongi, Filippo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c319t-54c968eb7d6edd0ae2ddc940936ee5712968adf8c7dea96e8df802c6bb45c9693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adenocarcinoma - drug therapy</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - radiotherapy</topic><topic>Adenocarcinoma - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Anal Canal</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Capecitabine - administration & dosage</topic><topic>Chemoradiotherapy</topic><topic>Digestive System Surgical Procedures - methods</topic><topic>Female</topic><topic>Fluorouracil - administration & dosage</topic><topic>Follow-Up Studies</topic><topic>Gastrointestinal Tract - radiation effects</topic><topic>Humans</topic><topic>Ileostomy</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoadjuvant Therapy - methods</topic><topic>Neoplasm Staging</topic><topic>Organ Sparing Treatments</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy, Adjuvant - adverse effects</topic><topic>Rectal Neoplasms - drug therapy</topic><topic>Rectal Neoplasms - pathology</topic><topic>Rectal Neoplasms - radiotherapy</topic><topic>Rectal Neoplasms - surgery</topic><topic>Retrospective Studies</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Urogenital System - radiation effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mazzola, Rosario</creatorcontrib><creatorcontrib>Ferrera, Giuseppe</creatorcontrib><creatorcontrib>Cucchiara, Teresa</creatorcontrib><creatorcontrib>Figlia, Vanessa</creatorcontrib><creatorcontrib>Gueci, Marina</creatorcontrib><creatorcontrib>Sciumè, Francesco</creatorcontrib><creatorcontrib>Di Paola, Gioacchino</creatorcontrib><creatorcontrib>Scibetta, Nunzia</creatorcontrib><creatorcontrib>Lo Casto, Antonio</creatorcontrib><creatorcontrib>Pappalardo, Maria Pia</creatorcontrib><creatorcontrib>Lagalla, Roberto</creatorcontrib><creatorcontrib>Alongi, Filippo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Tumori</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mazzola, Rosario</au><au>Ferrera, Giuseppe</au><au>Cucchiara, Teresa</au><au>Figlia, Vanessa</au><au>Gueci, Marina</au><au>Sciumè, Francesco</au><au>Di Paola, Gioacchino</au><au>Scibetta, Nunzia</au><au>Lo Casto, Antonio</au><au>Pappalardo, Maria Pia</au><au>Lagalla, Roberto</au><au>Alongi, Filippo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sequential Boost in Neoadjuvant Irradiation for T3N0-1 Rectal Cancer: Long-Term Results from a Single-Center Experience</atitle><jtitle>Tumori</jtitle><addtitle>Tumori</addtitle><date>2016-05-01</date><risdate>2016</risdate><volume>102</volume><issue>3</issue><spage>316</spage><epage>322</epage><pages>316-322</pages><issn>0300-8916</issn><eissn>2038-2529</eissn><abstract>Purpose
To evaluate the influence of radiation dose on tumor regression grade (TRG) and sphincter preservation rate in a series of cT3N0-1 rectal cancer patients treated with neoadjuvant chemoradiotherapy (CT-RT) with or without a sequential radiation boost.
Materials and methods
Between May 2002 and September 2013, 116 cases were eligible for retrospective evaluation. Radiotherapy was delivered for a total dose of 45 Gy (no boost arm) or 50.4 Gy (boost arm). TRG was evaluated with the Dworak scale.
Results
Median follow-up was 62 months (range, 12-138 months). The 5-year overall survival and local control rates were 72% and 93%, respectively. Fifty-five patients (47%) were treated with a sequential radiation boost and 61 (53%) without a boost. Eighty patients (72%) presented T3N0 disease and 32 (28%) T3N1 disease. Concomitant capecitabine was administered in 92 cases (79%) and intravenous 5-fluorouracil in 24 cases (21%). Sphincter preservation was performed in 82% of patients in the boost arm and 66% in the no-boost arm. A higher TRG was related to a longer interval between neoadjuvant treatment and surgery (p<0.001). The probability of a TRG ≥2 was 2.5 times higher in the boost arm. A gain in local control, estimated at 4% during the first 3 years after CT-RT, favored the boost arm.
Conclusions
The long-term results from our single-center experience confirm literature data on the role of a sequential boost in tumor response after neoadjuvant CT-RT in a series of cT3N0-1 rectal cancer patients.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>27002948</pmid><doi>10.5301/tj.5000481</doi><tpages>7</tpages></addata></record> |
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| ispartof | Tumori, 2016-05, Vol.102 (3), p.316-322 |
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| subjects | Adenocarcinoma - drug therapy Adenocarcinoma - pathology Adenocarcinoma - radiotherapy Adenocarcinoma - surgery Adult Aged Anal Canal Antineoplastic Agents - therapeutic use Capecitabine - administration & dosage Chemoradiotherapy Digestive System Surgical Procedures - methods Female Fluorouracil - administration & dosage Follow-Up Studies Gastrointestinal Tract - radiation effects Humans Ileostomy Kaplan-Meier Estimate Male Middle Aged Neoadjuvant Therapy - methods Neoplasm Staging Organ Sparing Treatments Radiotherapy Dosage Radiotherapy, Adjuvant - adverse effects Rectal Neoplasms - drug therapy Rectal Neoplasms - pathology Rectal Neoplasms - radiotherapy Rectal Neoplasms - surgery Retrospective Studies Time Factors Treatment Outcome Urogenital System - radiation effects |
| title | Sequential Boost in Neoadjuvant Irradiation for T3N0-1 Rectal Cancer: Long-Term Results from a Single-Center Experience |
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