|
KMID : 0939920180500031039
|
|
대한암학회지
2018 Volume.50 No. 3 p.1039 ~ p.1050
|
|
|
The Impact of Surgical Timing on Pathologic Tumor Response after Short Course and Long Course Preoperative Chemoradiation for Locally Advanced Rectal Adenocarcinoma
|
|
Lee Sea-Won
Lee Jong-Hoon
Lee In-Kyu
Oh Seong-Taek
Kim Dae-Yong
Kim Tae-Hyun
Oh Jae-Hwan
Baek Ji-Yeon
Chang Hee-Jin
Park Hee-Chul
Kim Hee-Cheol
Chie Eui-Kyu
Nam Taek-Keun
Jang Hong-Seok
|
|
|
Abstract
|
|
|
Purpose: A pooled analysis of multi-institutional trials was performed to analyze the effect of surgical timing on tumor response by comparing short course concurrent chemoradiotherapy (CCRT) with long course CCRT followed by delayed surgery in locally advanced rectal cancer.
Materials and Methods: Three hundred patients with cT3-4N0-2 rectal adenocarcinoma were included. Long course patients from KROG 14-12 (n=150) were matched 1:1 to 150 short course patients from KROG 10-01 (NCT01129700) and KROG 11-02 (NCT01431599) according to stage, age, and other risk factors. The primary endpoint was to determine the interval between surgery and the last day of neoadjuvant CCRT which yields the best tumor response after the short course and long course CCRT. Downstaging was defined as ypT0-2N0M0 and pathologic complete response (ypCR) was defined as ypT0N0M0, respectively.
Results: Both the long and short course groups achieved lowest downstaging rates at < 6 weeks (long 20% vs. short 8%) and highest downstaging rates at 6-7 weeks (long 44% vs. short 40%). The ypCR rates were lowest at < 6 weeks (both long and short 0%) and highest at 6-7 weeks (long 21% vs. short 11%) in both the short and long course arms. The downstaging and ypCR rates of long course group gradually declined after the peak at 6-7 weeks and those of the short course group trend to constantly increase afterwards.
Conclusion: It is optimal to perform surgery at least 6 weeks after both the short course and long course CCRT to obtain maximal tumor regression in locally advanced rectal adenocarcinoma.
|
|
|
KEYWORD
|
|
|
Rectal neoplasms, Chemoradiotherapy, Surgery interval
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
    
|