Locoregional Failure During and After Short-course Radiotherapy Followed by Chemotherapy and Surgery Compared With Long-course Chemoradiotherapy and Surgery

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Locoregional Failure During and After Short-course Radiotherapy Followed by Chemotherapy and Surgery Compared With Long-course Chemoradiotherapy and Surgery

Dijkstra, Esmee A. (author): Univ Groningen, Univ Med Ctr Groningen, Dept Med Oncol, Groningen, Netherlands.

Nilsson, Per J. (author): Karolinska Univ Hosp, Dept Surg, Stockholm, Sweden.

Hospers, Geke A. P. (author): Univ Groningen, Univ Med Ctr Groningen, Dept Med Oncol, Groningen, Netherlands.

Bahadoer, Renu R. (author): Leiden Univ, Med Ctr, Dept Surg, Leiden, Netherlands.

Meershoek-Klein Kranenbarg, Elma (author): Leiden Univ, Med Ctr, Dept Surg, Leiden, Netherlands.

Roodvoets, Annet G. H. (author): Leiden Univ, Med Ctr, Dept Surg, Leiden, Netherlands.

Putter, Hein (author): Leiden Univ, Med Ctr, Dept Med Stat & Bioinformat, Leiden, Netherlands.

Berglund, Åke (author): Uppsala universitet,Institutionen för immunologi, genetik och patologi

Cervantes, Andres (author): Univ Valencia, Biomed Res Inst Incl, Dept Med Oncol, Valencia, Spain.

Crolla, Rogier M. P. H. (author): Amphia Hosp, Dept Surg, Breda, Netherlands.

Hendriks, Mathijs P. (author): Northwest Clin, Dept Med Oncol, Alkmaar, Netherlands.

Capdevila, Jaume (author): Autonomous Univ Barcelona UAB, Vall Hebron Univ Hosp, Vall Hebron Inst Oncol VHIO, Dept Med Oncol, Barcelona, Spain.

Edhemovic, Ibrahim (author): Inst Oncol Ljubljana, Dept Surg Oncol, Ljubljana, Slovenia.

Marijnen, Corrie A. M. (author): Netherlands Canc Inst, Dept Radiat Oncol, Amsterdam, Netherlands.;Leiden Univ, Med Ctr, Dept Radiat Oncol, Leiden, Netherlands.

van de Velde, Cornelis J. H. (author): Leiden Univ, Med Ctr, Dept Surg, Leiden, Netherlands.

Glimelius, Bengt (author): Uppsala universitet,Institutionen för immunologi, genetik och patologi

van Etten, Boudewijn (author): Univ Groningen, Univ Med Ctr Groningen, Dept Surg, Groningen, Netherlands.

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Univ Groningen, Univ Med Ctr Groningen, Dept Med Oncol, Groningen, Netherlands Karolinska Univ Hosp, Dept Surg, Stockholm, Sweden. (creator_code:org_t)

Lippincott Williams & Wilkins, 2023
2023
English.
In: Annals of Surgery. - : Lippincott Williams & Wilkins. - 0003-4932 .- 1528-1140. ; 278:4, s. E766-E772

Related links:: https://urn.kb.se/re...; show more...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

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Objective:To analyze risk and patterns of locoregional failure (LRF) in patients of the RAPIDO trial at 5 years.Background:Multimodality treatment improves local control in rectal cancer. Total neoadjuvant treatment (TNT) aims to improve systemic control while local control is maintained. At 3 years, LRF rate was comparable between TNT and chemoradiotherapy in the RAPIDO trial.Methods:A total of 920 patients were randomized between an experimental (EXP, short-course radiotherapy, chemotherapy, and surgery) and a standard-care group (STD, chemoradiotherapy, surgery, and optional postoperative chemotherapy). LRFs, including early LRF (no resection except for organ preservation/R2 resection) and locoregional recurrence (LRR) after an R0/R1 resection, were analyzed.Results:Totally, 460 EXP and 446 STD patients were eligible. At 5.6 years (median follow-up), LRF was detected in 54/460 (12%) and 36/446 (8%) patients in the EXP and STD groups, respectively (P=0.07), in which EXP patients were more often treated with 3-dimensional-conformed radiotherapy (P=0.029). In the EXP group, LRR was detected more often [44/431 (10%) vs. 26/428 (6%); P=0.027], with more often a breached mesorectum (9/44 (21%) vs. 1/26 (4); P=0.048). The EXP treatment, enlarged lateral lymph nodes, positive circumferential resection margin, tumor deposits, and node positivity at pathology were the significant predictors for developing LRR. Location of the LRRs was similar between groups. Overall survival after LRF was comparable [hazard ratio: 0.76 (95% CI, 0.46-1.26); P=0.29].Conclusions:The EXP treatment was associated with an increased risk of LRR, whereas the reduction in disease-related treatment failure and distant metastases remained after 5 years. Further refinement of the TNT in rectal cancer is mandated.

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cancer and Oncol ...

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Locoregional Failure During and After Short-course Radiotherapy Followed by Chemotherapy and Surgery Compared With Long-course Chemoradiotherapy and Surgery

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