Efficacy evaluation of preoperative intensity-modulated radiotherapy combined with concurrent chemotherapy in patients with locally advanced rectal cancer / 肿瘤研究与临床

ABSTRACT

Objective To evaluate the efficacy and adverse reactions of preoperative intensity-modulated radiotherapy (IMRT) combined with mFOLFOX6 chemotherapy regimen for locally advanced rectal cancer (LARC). Methods A total of 86 patients with LARC who received preoperative IMRT combined with chemotherapy in Shanxi Provincial Cancer Hospital from June 2010 to December 2012 were enrolled. The patients were randomly divided into 2 groups according to the random number table method. Forty-six patients were treated with mFOLFOX6 regimen (mFOLFOX6 group) and 40 patients were treated with fluorouracil (5-Fu) single drug injection (5-Fu group). The total dose of IMRT target region was 45-54 Gy, 25 times in total. Short-term efficacy, adverse reactions, survival and metastasis were evaluated respectively. χ 2test or Fisher test were used to compare the count variable. Kaplan-Meier method was used to calculate the survival rates and Log-rank was used to detect. Results The total follow-up rate was 97.67 % (84/86). There were no statistical differences in the rate of resection (93.5 % vs. 80.0 %), pathological complete remission (pCR) rate (6.5 % vs. 0) and 3-year overall survival (OS) rate (87.0 % vs. 70.0 %) in the mFOLFOX6 group and 5-Fu group respectively (all P ＞ 0.05). Down-staging rate, 3-year disease free survival (DFS) rate and distant metastasis free survival (DMFS) rate in the mFOLFOX6 group were significantly higher than those in 5-Fu group (58.7 % vs. 32.5 %, 79.1 % vs. 50.0 %, 89.1 % vs. 72.5 %, all P ＜0.05). Conclusions Preoperative IMRT combined with mFOLFOX6 regimen can decrease the preoperative staging of LARC patients, improve 3-year DFS rate and DMFS rate. The adverse reactions may increase, but it is tolerant.