| Yao Bo,Wang Yadi,Lu Na,Liu Qingzhi,Chen Diandian.Outcomes for patients with locally recurrent rectal cancer treated with hypofractionated chemoradiotherapy without reresction[J].Chinese Journal of Radiological Medicine and Protection,2015,35(8):603-606,627 |
| Outcomes for patients with locally recurrent rectal cancer treated with hypofractionated chemoradiotherapy without reresction |
| Received:January 09, 2015 |
| DOI：10.3760/cma.j.issn.0254-5098.2015.08.010 |
| KeyWords:Rectal adenocarcinoma Local recurrence Hypofractionation Concurrent chemoradiotherapy Efficacy |
| FundProject: |
| Author Name | Affiliation | | Yao Bo | Department of Radiation Oncology, General Hospital of Beijing Military Command, PLA, Beijing 100700, China | | Wang Yadi | Department of Radiation Oncology, General Hospital of Beijing Military Command, PLA, Beijing 100700, China | | Lu Na | Department of Radiation Oncology, General Hospital of Beijing Military Command, PLA, Beijing 100700, China | | Liu Qingzhi | Department of Radiation Oncology, General Hospital of Beijing Military Command, PLA, Beijing 100700, China | | Chen Diandian | Department of Radiation Oncology, General Hospital of Beijing Military Command, PLA, Beijing 100700, China |
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| Abstract:: |
| Objective To analyze the response rate and prognostic factors for patients with locally recurrent rectal cancer treated with hypofractionated chemoradiotherapy without reresection. Methods Totally 52 patients with locally recurrent rectal cancer received hypofractionated irradiation and concurrent chemotherapy from January 2006 to January 2013 were enrolled. All patients received intensity-modulated radiotherapy (IMRT). The median dose was 63.4 Gy (61.6-64.4 Gy) at 2.2-2.3 Gy/f, 5 f/week. Thirteen patients underwent prophylactic irradiation at lymph nodes region, the total dose of 45-50.4 Gy with conventional fraction and a simultaneous integrated boost was used. All patients received concurrent chemotherapy, capecitabine at 1 650 mg•m-2•d-1, divided into 2 times, 5 d/week. The variables were compared by the chi-square test or Fisher's exact test. Local control (LC) and overall survival (OS) were calculated with using the Kaplan-Meier method. Results For all patients, the clinical complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD) was 23.1%, 38.5%, 32.7% and 5.8%, respectively. The response rate (CR+PR) for patients with previous irradiation to pelvis and without were 37.1% and 71.1%, respectively (χ2=5.40, P<0.05);for patients with 1 and 2 or more recurrent subsites were 81.8% and 46.7%,respectively (χ2=6.63, P<0.05). Acute grade 3 skin and hematologic toxicities occurred in 19 patients (36.5%) and 1 patient (1.9%), respectively. None occurred grade 4 toxicity and none occurred grade 3 or more gastrointestinal and urologic toxicities. Four patients showed severe late toxicity of anastomotic stricture and performed a stoma at transverse colon. No other severe late toxicities were observed. The LC at 5 years was 49.1% and the OS was 23.1%. Conclusions For patients with locally recurrent rectal cancer, hypofractionated chemoradiotherapy without resection is an acceptable and effective regimen, the response rate and long-term outcomes are promising. |
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