Radiat Oncol J.
2016 Jun;34(2):106-112. 10.3857/roj.2015.01585.
Predictors of pathologic complete response after preoperative concurrent chemoradiotherapy of rectal cancer: a single center experience
- Affiliations
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- 1Proton Therapy Center, National Cancer Center, Goyang, Korea.
- 2Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea. jhkim@dsmc.or.kr
- 3Department of Colorectal Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
- KMID: 2327383
- DOI: http://doi.org/10.3857/roj.2015.01585
Abstract
- PURPOSE
To identify possible predictors of pathologic complete response (pCR) of rectal cancer after preoperative concurrent chemoradiotherapy (CCRT).
MATERIALS AND METHODS
We conducted a retrospective review of 53 patients with rectal cancer who underwent preoperative CCRT followed by radical surgery at a single center between January 2007 and December 2012. The median radiotherapy dose to the pelvis was 54.0 Gy (range, 45.0 to 63.0 Gy). Five-fluorouracil-based chemotherapy was administered via continuous infusion with leucovorin.
RESULTS
The pCR rate was 20.8%. The downstaging rate was 66%. In univariate analyses, poor and undifferentiated tumors (p = 0.020) and an interval of ≥7 weeks from finishing CCRT to surgery (p = 0.040) were significantly associated with pCR, while female gender (p = 0.070), initial carcinoembryonic antigen concentration of <5.0 ng/dL (p = 0.100), and clinical stage T2 (p = 0.100) were marginally significant factors. In multivariate analysis, an interval of ≥7 weeks from finishing CCRT to surgery (odds ratio, 0.139; 95% confidence interval, 0.022 to 0.877; p = 0.036) was significantly associated with pCR, while stage T2 (odds ratio, 5.363; 95% confidence interval, 0.963 to 29.877; p = 0.055) was a marginally significant risk factor.
CONCLUSION
We suggest that the interval from finishing CCRT to surgery is a predictor of pCR after preoperative CCRT in patients with rectal cancer. Stage T2 cancer may also be an important predictive factor. We hope to perform a robust study by collecting data during treatment to obtain more advanced results.
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