Prog Med Phys.  2018 Dec;29(4):143-149. 10.14316/pmp.2018.29.4.143.

Feasibility Assessment of Physical Factors of Rectal Cancer Short-Course Chemoradiotherapy with Delayed Surgery

• Koo J
• Chung M
• Chung WK
• Jin S
• Kim DW

• KMID: 2434648
• DOI: http://doi.org/10.14316/pmp.2018.29.4.143

Abstract

To verify the correlations between the clinical outcomes and physical factors of short-course chemoradiotherapy (SCRT) and long-course chemoradiotherapy (LCRT) with delayed surgery in patients with rectal cancer. Seventy-two patients with rectal cancer were enrolled in this study. Nineteen patients were treated with SCRT (25 Gy, 5 fractions) by intensity-modulated radiation therapy (IMRT), and 53 patients were treated with LCRT (50.4 Gy, 28 fractions) by three-dimensional conformal radiation therapy (3DCRT). Various physical factors for the target and organs at risk (OARs) were calculated to compare the clinical outcomes. The organ equivalent dose (OED) and lifetime attributable risk (LAR) of bowels and bladders were similar between the SCRT and LCRT groups, whereas the values of femurs were higher in the LCRT group. The equivalent uniform dose and normal tissue complication probability were higher in the LCRT than the SCRT group for most organs. Treatment complications, including anastomotic leakage, bowel adhesion, and hematologic toxicity, were not significantly different between SCRT and LCRT groups. CIs were 0.84±0.2 and 0.61±0.1 for SCRT and LCRT, respectively. The CVIs were 1.07±0.0 and 1.10±0.1, and the HIs were 0.09±0.0 and 0.11±0.1 for SCRT and LCRT, respectively. The sphincter-saving rates were 89.5% and 94.3% for SCRT and LCRT, respectively. The complete pathologic remission rates were 21.1% and 13.2%, and the down-staging rates were 47.4% and 26.4% for SCRT and LCRT, respectively. SCRT with IMRT is comparable to conventional LCRT in both physical indexes and clinical outcome. The preoperative SCRT, compensated by IMRT, is an effective and safe modality.

Keyword

Chemoradiotherapy; Preoperative treatment; Rectal cancer; Physical Index; Short course

MeSH Terms

Anastomotic Leak
Chemoradiotherapy*
Clothing
Femur
Humans
Organs at Risk
Rectal Neoplasms*
Urinary Bladder

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