The initially results of neoadjuvant chemoradiation followed by consolidation chemotherapy for stage II, III rectal cancer patients
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Abstract
Objective: To evaluate the clinical complete response (cCR) and related factors in stage II-III rectal cancer patients treated with neoadjuvant chemoradiation followed by consolidation chemotherapy (total neoadjuvant therapy) before surgery. Subject and method: 36 rectal cancer patients at stage II-III underwent preoperative chemoradiationof 50.4Gy/28fx concurrent with Capecitabine 825mg/m2, twice a day × 5 days/week followed by 12-16 weeks consolidation chemotherapy of FOLFOX or CAPEOX from April 2022 to April 2023 at Nghe An Oncology Hospital. Treatment response were assessed at the time of 6-12 weeks and 18-24 weeks from the last day of radiotherapyby digital rectal examination, flexible rectoscopy, and pelvic MRI. The relationship between clinical factors and cCR was evaluated. Result: The cCR rates were 11.1% at 6-12 weeks and 36.1% at 18-24 weeks post radiotherapy. There were statistically significant differences in cCR rates among the following groups: tumor stage T2-3 (43.3%) versus T4 (0%), nodal stage N0 (100%) versus N1 (40%) and N2 (22.7%), scarbrous tumor (66.7%) versus ulcerated - scabrous tumor (20.8%), and tumor length ≤ 4cm (72.2%) versus > 4cm (0%) (p<0.05). Conclusion: The percentage of patients who achieved cCR at 18-24 weeks was higher than at 6-12 weeks after the end of radiotherapy. Tumors ≤ T3, lymph nodes N0, tumor length ≤ 4cm, scarbrous morphology had high cCR rates.
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