Neoadjuvant chemoradiotherapy delivered with helical tomotherapy under daily image guidance for rectal cancer patients: efficacy and safety in a large, multi-institutional series.

Détails

ID Serval
serval:BIB_89462433D524
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Neoadjuvant chemoradiotherapy delivered with helical tomotherapy under daily image guidance for rectal cancer patients: efficacy and safety in a large, multi-institutional series.
Périodique
Journal of cancer research and clinical oncology
Auteur(s)
De Bari B., Franzetti-Pellanda A., Saidi A., Biggiogero M., Hahnloser D., Montemurro M., Bourhis J., Zeverino M., Ozsahin M.
ISSN
1432-1335 (Electronic)
ISSN-L
0171-5216
Statut éditorial
Publié
Date de publication
04/2019
Peer-reviewed
Oui
Volume
145
Numéro
4
Pages
1075-1084
Langue
anglais
Notes
Publication types: Clinical Trial ; Journal Article ; Multicenter Study
Publication Status: ppublish
Résumé
Helical tomotherapy (HT) has been recently introduced in the neoadjuvant treatment of locally advanced rectal cancer. Aim of this study is to report the toxicity and local control rates of a large series of locally advanced rectal cancer patients treated with neoadjuvant chemotherapy and HT under daily image guidance followed by surgery.
Data from 117 locally advanced rectal cancer patients treated at two Swiss Radiotherapy departments were collected and analyzed. Radiotherapy consisted of 45 Gy (1.8 Gy/fraction, 5 fractions/week delivered in 5 weeks) to the regional pelvic lymph nodes. Seventy patients also received a simultaneous integrated boost (SIB) up to 50 Gy to the tumor and involved nodes (2 Gy/fraction, 5 fractions/week delivered in 5 weeks). Chemotherapy consisted of capecitabine 825 mg/m <sup>2</sup> , twice daily, during the irradiation days. After a median interval of 59 days [95% confidence interval (CI) 53-65 days), all patients underwent surgery.
Median follow-up was 45 months (range 4-90 months). The overall rate of acute grade 2-4 toxicity was 18.8% (n = 22). Four patients (3.4%) presented a grade 3 dermatitis (n = 1) or diarrhea (n = 3), and 1 (0.8%) demonstrated grade 4 rectal toxicity. No patients presented with grade ≥ 3 hematologic toxicity. Six patients (5.1%) had late grade 3 gastrointestinal toxicity. The 4-year local control rate was 88.4% (95% CI 87.5-88.5%).
Neoadjuvant chemoradiotherapy delivered with HT under daily image guidance is well tolerated and shows a high 4-year local control rates.
Mots-clé
Adult, Aged, Aged, 80 and over, Antimetabolites, Antineoplastic/therapeutic use, Capecitabine/therapeutic use, Chemoradiotherapy, Adjuvant, Female, Humans, Male, Middle Aged, Neoadjuvant Therapy, Neoplasm Staging, Radiotherapy, Image-Guided, Rectal Neoplasms/diagnostic imaging, Rectal Neoplasms/drug therapy, Rectal Neoplasms/radiotherapy, Rectal Neoplasms/therapy, Tomography, X-Ray Computed, Whole Body Imaging, Helical tomotherapy, Image-guided radiotherapy, Neoadjuvant chemoradiotherapy, Rectal cancer, Toxicity
Pubmed
Web of science
Création de la notice
07/04/2019 14:12
Dernière modification de la notice
20/08/2019 14:48
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