Oncologic outcomes of neoadjuvant chemoradiation for locally advanced rectal cancer: a single-institution experience
Annals of the Academy of Medicine, Singapore
; : 569-575, 2014.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-312221
Responsible library:
WPRO
ABSTRACT
<p><b>INTRODUCTION</b>This study reports the outcomes of patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation followed by surgery in a local population of Singapore.</p><p><b>MATERIALS AND METHODS</b>The records of 85 patients who underwent neoadjuvant chemoradiation for locally advanced rectal cancer followed by surgery at the Tan Tock Seng Hospital (TTSH) between November 2002 and January 2012 were reviewed. The treatment protocol comprised radiotherapy to a total dose of 50.4 Gy concurrent with 5-fluorouracil-based chemotherapy. Patients underwent total mesorectal excision surgery following the completion of neoadjuvant chemoradiation. Local control, disease-free survival and overall survival were analysed using Kaplan-Meier methods.</p><p><b>RESULTS</b>Median age of the patients was 61 years. All of them completed radiotherapy. One patient did not complete neoadjuvant chemotherapy. The median time to surgery was 52 days. Fifty-five percent (47 of 85) of patients achieved pathological downstaging and 13% (11 of 85) of patients had a pathologic complete response to preoperative treatment. The neoadjuvant chemoradiation was well tolerated. Four percent of patients had grade 3 diarrhoea and 4% of them had grade 3 dermatitis. There were no grade 4 toxicities. With a median follow-up of 41 months, the 5-year actuarial local recurrence, disease-free survival and overall survival rates were 7%, 71.9%, and 83.2% respectively. Univariate analysis showed that patients with positive surgical margins had significantly worse disease-free survival and overall survival (P=0.012 and P<0.001 respectively) and a trend towards a higher rate of local recurrence (P=0.08).</p><p><b>CONCLUSION</b>Our study provides evidence that neoadjuvant chemoradiation is an effective treatment for locally advanced rectal cancer. Our outcomes are comparable with internationally published data and demonstrate the reproducibility of the neoadjuvant approach in an Asian population.</p>
Full text:
Available
Health context:
Neglected Diseases
Health problem:
Diarrhea
Database:
WPRIM (Western Pacific)
Main subject:
Pathology
/
Rectal Neoplasms
/
Therapeutics
/
Treatment Outcome
/
Neoadjuvant Therapy
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Chemoradiotherapy, Adjuvant
/
Neoplasm Staging
Type of study:
Practice guideline
Limits:
Adult
/
Aged
/
Aged, 80 and over
/
Female
/
Humans
/
Male
Language:
English
Journal:
Annals of the Academy of Medicine, Singapore
Year:
2014
Document type:
Article