| Author/Editor | But-Hadžić, Jasna; Anderluh, Franc; Brecelj, Erik; Edhemović, Ibrahim; Šečerov Ermenc, Ajra; Hudej, Rihard; Jeromen, Ana; Koželj, Miran; Krebs, Bojan; Oblak, Irena; Omejc, Mirko; Vogrin, Andrej; Velenik, Vaneja | |
| Title | Acute toxicity and tumor response in locally advanced rectal cancer after preoperative chemoradiation therapy with shortening of the overall treatment time using intensity-modulated radiation therapy with simultaneous integrated boost | |
| Type | članek | |
| Vol. and No. | Letnik 96, št. 5 | |
| Publication year | 2016 | |
| Volume | str. 1003-1010 | |
| ISSN | 0360-3016 - International journal of radiation oncology, biology, physics | |
| Language | eng | |
| Abstract | Background and Purpose: This phase 2 study investigated the efficacy and safety of preoperative intensity modulated radiation therapy with a simultaneous integrated boost (IMRT-SIB) without dose escalation, concomitant with standard capecitabine chemotherapy in locally advanced rectal cancer. Methods and Materials: Between January 2014 and March 2015, 51 patients with operable stage II-III rectal adenocarcinoma received preoperative IMRT with pelvic dose of 41.8 Gy and simultaneously delivered 46.2 Gy to T2/3 and 48.4 Gy to T4 tumor in 22 fractions, concomitant with capecitabine, 825 mg/m2/12 hours, including weekends. The primary endpoint was pathologic complete response (pCR). Results: Fifty patients completed preoperative treatment according to the protocol, and 47 underwent surgical resection. The sphincter preservation rate for the low rectal tumors was 62%, and the resection margins were free in all but 1 patient. Decrease in tumor and nodal stage was observed in 32 (68%) and 39 (83%) patients, respectively, with pCR achieved in 12 (25.5%) patients. There were only 2 G % 3 acute toxicities, with infectious enterocolitis in 1 patient and dermatitis over the sacral area caused by the bolus effect of the treatment table in the second patient. Conclusions: Preoperative IMRT-SIB without dose escalation is well tolerated, with a low acute toxicity profile, and can achieve a high rate of pCR and downstaging. | |
| Keywords | rak danke kemoradioterapija predoperativno zdravljenje lokalno napredovali rak rectal cancer chemoradiation therapy preoperative chemoradiation therapy locally advanced cancer |