Gastrointestinal Cancer

SS 17 - GI 3 - Colon/Rectum/Anus

129 - Efficacy of Preoperative Neoadjuvant Simultaneous Integrated Boost IMRT Radiation Therapy Combined With Preoperative Chemotherapy for Locally Advanced Rectal Cancer: A Prospective II Clinical Study

Monday, October 22
4:45 PM - 4:55 PM
Location: Room 214 C/D

Efficacy of Preoperative Neoadjuvant Simultaneous Integrated Boost IMRT Radiation Therapy Combined With Preoperative Chemotherapy for Locally Advanced Rectal Cancer: A Prospective II Clinical Study
Q. Liu1,2, L. Feng2, B. Qu2, L. Ma2, B. Jia3, G. Dai4, X. Du3, H. Liu3, Y. Gao1, Y. Wang2, and J. Chen2; 1Department of Radiation Oncology, Beijing Luhe Hospital, Beijing, China, 2Department of Radiation Oncology, Chinese PLA General Hospital, Beijing, China, 3Department of General Surgery, Chinese PLA General Hospital, Beijing, China, 4Department of Medical Oncology, Chinese PLA General Hospital, Beijing, China

Purpose/Objective(s): To evaluate the feasibility, safety and short-term efficacy of preoperative capecitabine and simultaneous integrated boost IMRT-based, followed by a cycle of neoadjuvant capecitabine in patients with locally advanced rectal cancer(LARC).

Materials/Methods: Between March 2015 and July 2016, a total of 43 patients with resectable stage Ⅱor Ⅲ rectal cancer received capecitabine (825 mg/m2, bid d1-5 weekly) and SIB-IMRT delivering 58.75 Gy (2.35Gy/fraction) to the gross tumor and regional metastatic lymph nodes while simultaneously delivering 50Gy (2.0 Gy/fraction) to the areas at high risk for harboring microscopic disease. One cycle of capecitabine (1250 mg/m2, bid d1-14) was given one week after the completion of neoadjuvant chemoradiation (nCRT), and TME was scheduled 6 to 8 weeks after the completion of nCRT. The primary endpoint included ypCR. Secondary endpoints included acute toxicity, tumor downstaging, surgical morbidity, R0 resection, postoperative complications, sphincter preservation rate, LR, OS, and DFS.

Results: 43 patients completed chemoradiation as the protocal schedule and 40 received surgical resection. 16 (40%) patients had no residual tumor in the surgical specimen. Downstageing of the primary tumor or lymph nodes was observed in 39 (97.5%) patients. Most of the adverse reactions were grade 1/2, Grade 3 diarrhea and radiation dermatitis toxicities were evaluated in two (4.7%) and three cases (7.0%). No grade 4-5 toxicities were observed. Thirty patients underwent sphincter-saving surgery. Postoperative complications included 1 case of ureteral injury and 1 case of intestinal obstruction, no death in perioperative period. Three patients who refused surgery after chemoradiation therapy were excluded from the analysis, included one patient delayed surgery due to anal edema. The 1-year estimated overall survival and disease-free survival rates were 100 and 100% respectively, and no local relapse was found.

Conclusion: The pattern of preoperative SIB-IMRT plus concurrent capeciabine, followed by one cycle neoadjuvant capecitabine is a safe, well-tolerated treatment, gained a good pCR for patients with locally advanced rectal cancer, and the short term outcomes could be promising.

Author Disclosure: Q. Liu: None. L. Feng: None. B. Qu: None.

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129 - Efficacy of Preoperative Neoadjuvant Simultaneous Integrated Boost IMRT Radiation Therapy Combined With Preoperative Chemotherapy for Locally Advanced Rectal Cancer: A Prospective II Clinical Study



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