1. Adding Three Cycles of CAPOX after Neoadjuvant Chemoradiotherapy Increases the Rates of Complete Response for Locally Advanced Rectal Cancer
- Author
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Zhen-Jun Wang, Kunning Zhang, Lixia Wang, Jiannan Yao, Tian Zhang, Zhiwei Zhai, and Chen Wang
- Subjects
medicine.medical_specialty ,Colorectal cancer ,Locally advanced ,Article ,law.invention ,Capecitabine ,Randomized controlled trial ,law ,medicine ,consolidation chemotherapy ,Humans ,Radical surgery ,rectal cancer ,Complete response ,RC254-282 ,Neoplasm Staging ,Retrospective Studies ,business.industry ,Rectal Neoplasms ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Consolidation Chemotherapy ,Chemoradiotherapy ,medicine.disease ,musculoskeletal system ,total neoadjuvant chemoradiotherapy ,Neoadjuvant Therapy ,Surgery ,Treatment Outcome ,pathological complete response ,business ,Neoadjuvant chemoradiotherapy ,medicine.drug - Abstract
Background and Objectives: the total neoadjuvant chemoradiotherapy (TNT) includes different strategies, but the most appropriate model remains uncertain. The purpose of this retrospectively study was to evaluate the safety and pathological response in the consolidation chemotherapy model. Methods: patients with cT3/T4 or TxN + M0 rectal cancer that were receiving neoadjuvant chemoradiotherapy (CRT) (50 Gy with oral capecitabine)/TNT (CRT followed by three cycles of CAPOX) during September 2017 to September 2019 in our department were included. All of the patients were recommended to receive radical surgery. Results: a total of 197 patients were included. Eighty-one patients received CRT, while one hundred and sixteen patients received TNT. Nine patients did not undergo surgery because of the distant metastases (one patient (1.2%) in CRT group, two patients (1.7%) in TNT group) or a refusal of resection (two patients in CRT group, four patients in TNT group). The pathological complete response (pCR) rate was 32.7% in TNT compared with 12.8% in CRT (p = 0.002). There was no statistically significant difference in grade 3 acute toxicities of neoadjuvant treatment and surgical complications between the two groups. Conclusions: the consolidation chemotherapy model is safe for patients with locally advanced rectal cancer and it has a high pCR rate. The long-term follow-up is necessary to be evaluated in a future prospective, randomized trial.
- Published
- 2021