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. 2020 Jun;11(6):e00162.
doi: 10.14309/ctg.0000000000000162.

Short-Course Radiotherapy in Locally Advanced Rectal Cancer

Maria Cambray  1 , Javier Gonzalez-Viguera  1 , Miguel Angel Berenguer  1 , Miquel Macià  1 , Ferran Losa  1 , Gemma Soler  1 , Ricard Frago  2 , J Castellví  3 , E Guinó  4
Affiliations

Short-Course Radiotherapy in Locally Advanced Rectal Cancer

Maria Cambray et al. Clin Transl Gastroenterol. 2020 Jun.

Abstract

Introduction: To date, we do not know the best therapeutic scheme in locally advanced rectal cancer when patients are older or have comorbidities.

Methods: In 2009, we established a prospective treatment protocol that included short-course preoperative radiotherapy (RT) with standard surgery +/- chemotherapy in frail patients, mostly older than 80 years or with comorbidities.

Results: We included 87 patients; the mean follow-up was 43.5 months (0.66-106.3). Disease-specific survival and disease-free survival at 36 months were 86.3% and 82.8%; at 60 months, they were 78.2% and 78%, respectively, with a local recurrence rate of 2.5%. The rate of late radiotoxicity was 9% in the form of sacral insufficiency fracture and small bowel obstruction with one death. The interval before surgery varied according to the involvement of the mesorectal fascia, but it was less than 2 weeks in 45% of cases. The rate of R0 was 95%. Surgical complications included abdominal wound dehiscence (3.5%), anastomotic leak (2.4%), and reoperations (11.5%). Downstaging was observed in 51% of the cases, regardless of the interval before surgery.

Discussion: Therapeutic outcomes in our group of elderly patients and/or patients with comorbidities with neoadjuvant short-course RT are such as those of the general population treated with neoadjuvant RT-chemotherapy, all with acceptable toxicity. Therefore, this treatment scheme, with short-course preoperative RT, would be the most appropriate in this group of patients.

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Conflict of interest statement

Guarantor of the article: Maria Cambray.

Specific author contributions: Conceptualization, M.C.; methodology, M.C and J.G.; formal analysis, M.C, J.G and M.A.B.; investigation, M.C, M.M, F.L, G.S, R.F and J.C.; writing—original draft preparation, M.C.; writing—review and editing, M.C, J.G, M.A.B, M.M and F.L.; supervision, M.C and F.L; project administration, M.C and E.G. funding acquisition, M.C and F.L.

Financial support: This research was funded by Catalan Institute of Oncology.

Potential competing interests: None to report.

Figures

Figure 1.
Figure 1.
Disease-specific survival. CI, confidence interval.
Figure 2.
Figure 2.
Disease-free survival. CI, confidence interval.
See this image and copyright information in PMC

References

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