Clinical efficacy of preoperative neoadjuvant chemoradiotherapy for unresectable locally advanced adherent colon cancer in 40 patients
10.3760/cma.j.issn.1004-4221.2017.05.012
- VernacularTitle:40例局部晚期结肠癌术前neoCRT临床分析
- Author:
Xin YU
;
Weiwei XIAO
;
Qiaoxuan WANG
;
Suping GUO
;
Zhifan ZENG
;
Peirong DING
;
Liren LI
;
Gong CHEN
;
Zhizhong PAN
;
Deseng WAN
;
Yuanhong GAO
- Keywords:
Intestinal neoplasms/radiotherapy;
Intestinal neoplasms/chemotherapy;
Short-term effect
- From:
Chinese Journal of Radiation Oncology
2017;26(5):538-541
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy and toxicities of neoadjuvant chemoradiotherapy (neoCRT) in the management of unresectable locally advanced adherent colon cancer (LAACC).Methods A retrospective analysis was performed on the clinical records of 40 patients with initially diagnosed unresectable LAACC who received preoperative neoCRT in our center from October 2010 to December 2015.Results Thirty-nine patients completed the preoperative neoCRT.Thirty-four patients underwent radical resection after neoCRT, and the R0 resection rate, pathological complete response rate (pCR), tumor downstaging rate, nodal downstaging rate, and clinical downstaging rate were 91%, 24%(8/34patients), 76%(26/34patients),100%(32/32patients), and 94%(32/34patients), respectively.Among the 21 patients with bladder invasion, the full bladder was preserved in 7 patients (33%) and partial cystectomy was performed in 11 patients (52%).During the course of neoCRT, the grade 3-4 hematologic toxicity rate, grade 3 hand-foot syndrome rate, grade 3 radiodermatitis, and incomplete intestinal obstruction rate were 23%, 3%, 3%, and 5%, respectively.The 3-year sample size was 25 patients.For all the patients, the 3-year overall survival (OS) and progression-free survival (PFS) rates were 75% and 80%, respectively.Of the 34 patients who received surgical radical resection, the 3-year OS and disease-free survival (DFS) rates were 87% and 81%, respectively.In addition, local tumor recurrence was identified in 3 patients, and distant metastasis was identified in 6 patients.Conclusions NeoCRT is an effective treatment for unresectable LAACC that results in significant tumor downstaging and enhanced R0 resection rate without an increase in surgical complications.The patients treated with radical surgical resection after neoCRT show a satisfactory short-term outcome.Further studies will be required to determine the clinical value of neoCRT in treating LAACC.
