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

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

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • Lippincott Williams & Wilkins,2023
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-515346
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-515346URI
  • https://doi.org/10.1097/SLA.0000000000005799DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • 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.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Nilsson, Per J.Karolinska Univ Hosp, Dept Surg, Stockholm, Sweden. (author)
  • Hospers, Geke A. P.Univ Groningen, Univ Med Ctr Groningen, Dept Med Oncol, Groningen, Netherlands. (author)
  • Bahadoer, Renu R.Leiden Univ, Med Ctr, Dept Surg, Leiden, Netherlands. (author)
  • Meershoek-Klein Kranenbarg, ElmaLeiden Univ, Med Ctr, Dept Surg, Leiden, Netherlands. (author)
  • Roodvoets, Annet G. H.Leiden Univ, Med Ctr, Dept Surg, Leiden, Netherlands. (author)
  • Putter, HeinLeiden Univ, Med Ctr, Dept Med Stat & Bioinformat, Leiden, Netherlands. (author)
  • Berglund, ÅkeUppsala universitet,Institutionen för immunologi, genetik och patologi(Swepub:uu)akebergl (author)
  • Cervantes, AndresUniv Valencia, Biomed Res Inst Incl, Dept Med Oncol, Valencia, Spain. (author)
  • Crolla, Rogier M. P. H.Amphia Hosp, Dept Surg, Breda, Netherlands. (author)
  • Hendriks, Mathijs P.Northwest Clin, Dept Med Oncol, Alkmaar, Netherlands. (author)
  • Capdevila, JaumeAutonomous Univ Barcelona UAB, Vall Hebron Univ Hosp, Vall Hebron Inst Oncol VHIO, Dept Med Oncol, Barcelona, Spain. (author)
  • Edhemovic, IbrahimInst Oncol Ljubljana, Dept Surg Oncol, Ljubljana, Slovenia. (author)
  • Marijnen, Corrie A. M.Netherlands Canc Inst, Dept Radiat Oncol, Amsterdam, Netherlands.;Leiden Univ, Med Ctr, Dept Radiat Oncol, Leiden, Netherlands. (author)
  • van de Velde, Cornelis J. H.Leiden Univ, Med Ctr, Dept Surg, Leiden, Netherlands. (author)
  • Glimelius, BengtUppsala universitet,Institutionen för immunologi, genetik och patologi(Swepub:uu)bengglim (author)
  • van Etten, BoudewijnUniv Groningen, Univ Med Ctr Groningen, Dept Surg, Groningen, Netherlands. (author)
  • Investigators, Collaborative(author)
  • Univ Groningen, Univ Med Ctr Groningen, Dept Med Oncol, Groningen, Netherlands.Karolinska Univ Hosp, Dept Surg, Stockholm, Sweden. (creator_code:org_t)

Related titles

  • In:Annals of Surgery: Lippincott Williams & Wilkins278:4, s. E766-E7720003-49321528-1140

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