1. Neoadjuvant chemoradiotherapy in patients with unresectable locally advanced sigmoid colon cancer: clinical feasibility and outcome
- Author
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Li Ren Li, Yan Yuan, Qiao Xuan Wang, Xiaojun Wu, Zhen Hai Lu, Shao Qing Niu, Wei Wei Xiao, Zhi Fan Zeng, Pei-Rong Ding, Rong Zhen Li, Wei Hao Xie, Yuanhong Gao, and Hui Chang
- Subjects
Male ,medicine.medical_treatment ,R895-920 ,Medical physics. Medical radiology. Nuclear medicine ,0302 clinical medicine ,Antineoplastic Combined Chemotherapy Protocols ,Sigmoid colon cancer ,RC254-282 ,Colectomy ,Down staging ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Radiotherapy Dosage ,Chemoradiotherapy ,Middle Aged ,Neoadjuvant Therapy ,Progression-Free Survival ,Neoadjuvant chemoradiotherapy ,Survival Rate ,Oncology ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,030211 gastroenterology & hepatology ,Female ,medicine.drug ,Adult ,medicine.medical_specialty ,Organ preservation ,Capecitabine ,03 medical and health sciences ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Retrospective Studies ,Chemotherapy ,Pathological complete response ,Lymphatic Irradiation ,business.industry ,Research ,Retrospective cohort study ,medicine.disease ,Surgery ,Lymphoma ,Radiation therapy ,Regimen ,Sigmoid Neoplasms ,Radiotherapy, Intensity-Modulated ,business ,Organ Sparing Treatments - Abstract
Background Patients with locally advanced sigmoid colon cancer (LASCC) have limited treatment options and a dismal prognosis with poor quality of life. This retrospective study aimed to further evaluate the feasibility and efficacy of neoadjuvant chemoradiotherapy (NACRT) followed by surgery as treatment for select patients with unresectable LASCC. Methods We studied patients with unresectable LASCC who received NACRT between November 2010 and April 2019. The NACRT regimen consisted of intensity modulated radiotherapy (IMRT) of 50 Gy to the gross tumor and positive lymphoma node and 45 Gy to the clinical target volume. Capecitabine‑based chemotherapy was administered every 2 (mFOLFOX6) or 3 weeks (CAPEOX). Surgery was scheduled 6–8 weeks after radiotherapy. Results Seventy‑two patients were enrolled in this study. Patients had a regular follow-up (median, 41.1 months; range, 8.3–116.5 months). Seventy‑one patients completed NACRT, and sixty-five completed surgery. Resection with microscopically negative margins (R0 resection) was achieved in 64 patients (88.9%). Pathologic complete response was observed in 15 patients (23.1%), and multivisceral resection was necessary in 38 patients (58.3%). The cumulative probability of 3-year overall survival (OS) and progression-free survival (PFS) were 75.8 and 70.7%, respectively. Conclusions For patients with unresectable LASCC, neoadjuvant chemoradiotherapy is feasible, surgery can be performed safely and may result in increased survival and organ preservation rates.
- Published
- 2021