Comparison of long term effects between preoperative simultaneous integrated boost intensity-modulated radiation therapy and three dimensional conformal radiotherapy for locally advanced rectal cancer
10.3969/j.issn.1671-8348.2024.14.005
- VernacularTitle:局部晚期直肠癌术前同期加量调强放疗与三维适形放疗的远期疗效比较
- Author:
Yingshan CUI
1
;
Shubo DING
Author Information
1. 金华市中心医院放疗科,浙江金华 321000
- Keywords:
locally advanced rectal cancer;
intensity-modulated radiation therapy;
simultaneous integrated boost;
prognosis;
neoadjuvant chemoradiotherapy
- From:
Chongqing Medicine
2024;53(14):2104-2109
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the long-term effects and later period toxic reactions between preop-erative simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) and 3-dimensional conformal radiotherapy RT (3D-CRT) for locally advanced rectal cancer.Methods A total of 130 patients with clinical stage cT3-4/N+M0 rectal adenocarcinoma receiving neoadjuvant chemoradiotherapy in this hos-pital from May 2010 to May 2015 were selected as the study subjects.The patients were divided into the SIB-IMRT group (66 cases) and 3D-CRT group (64 cases) according to the random number table method.The SIB-IMRT group took the irradiation 55 Gy/25 frequencies,irradiation 45 Gy/25 frequencies in the high risk recurrent region and regional lymphatic drainage area.The 3-DCRT group took the irradiation 45 Gy/25 fre-quencies in the high risk recurrent region and regional lymphatic drainage area.All patients orally took capecitabine (825 mg/m2) on 1-14 d and 22-35 d of radiotherapy (twice daily) in synchronized radiothera-py.The total mesorectal excision was performed in 6-8 weeks after radiotherapy end.The overall survival (OS) rate,disease free survival (DFS) rate,locoregional recurrence free survival (LRFS) rate,distant metas-tasis rate (DMR) and occurrence situation of advanced stage toxic reactions were observed and compared be-tween the two groups.Results The median follow-up time of all study subjects was 105(2,136) months.The 10-year OS rate,DFS rate,LRFS rate and DMR in the SIB-IMRT group was 67.8％,64.5％,91.8％ and 29.9％ respectively,which in the 3D-CRT group was 62.6％,61.2％,88.7％ and 34.5％ respectively,but the differences were not statistically significant (P>0.05).The grade 2 and 3 adverse reactions in the SIB-IMRT group were higher than those in the 3D-CRT group (34.48％ vs. 28.07％),but the difference was not statistically significant (P>0.05).Conclusion SIB-IMRT provides the acceptable long term effect and toxic results than 3D-CRT.
