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Erschienen in: International Journal of Colorectal Disease 7/2022

18.06.2022 | Original Article

Impact of total neoadjuvant therapy consisting of consolidation chemotherapy on locally advanced rectal cancer survival

verfasst von: Haoyu Zhang, Ganbin Li, Ke Cao, Zhiwei Zhai, Guanghui Wei, Hao Qu, Zhenjun Wang, Jiagang Han

Erschienen in: International Journal of Colorectal Disease | Ausgabe 7/2022

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Abstract

Purpose

The objective was to compare disease-free survival (DFS) and distant metastasis in patients with neoadjuvant chemoradiotherapy (NCRT) and total neoadjuvant therapy (TNT) for locally advanced rectal cancer.

Methods

Patients with cT3-4N0M0 or cTxN1-2M0 rectal cancer were included in this retrospective study. Patients who received NCRT (radiotherapy with concurrent capecitabine) or TNT (radiotherapy with two concurrent cycles of capecitabine and oxaliplatin (CAPOX) followed by another two cycles of CAPOX) during January 2011 and November 2016 at Beijing Chaoyang Hospital, Capital Medical University were included. All patients had received radical surgery. Adverse events, pathological response and survival outcomes in the two groups were compared.

Results

One hundred eighty-two patients were enrolled, 120 in the TNT and 62 in the NCRT groups. No significant between-group differences in neoadjuvant therapy-associated adverse events or surgical complications were found. TNT achieved a higher pathological complete response (pCR) rate (25.8%) compared with NCRT (12.9%, P = 0.044). Patients in the TNT group had a higher 3-year DFS rate (82.8% versus 75.7%, P = 0.041) and lower distant metastasis rate (19.2% versus 33.1%, P = 0.049) than those in the NCRT group. Multivariate analysis showed that NCRT was an independent risk factor for DFS (95%CI 2.023–13.415, P = 0.001) and distant metastasis (95% CI 2.149–20.082, P = 0.001).

Conclusion

With similar adverse events and a higher pCR rate when compared with NCRT, TNT might be considered as a safe and effective therapeutic strategy to improve prognosis in patients with locally advanced rectal cancer.
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Metadaten
Titel
Impact of total neoadjuvant therapy consisting of consolidation chemotherapy on locally advanced rectal cancer survival
verfasst von
Haoyu Zhang
Ganbin Li
Ke Cao
Zhiwei Zhai
Guanghui Wei
Hao Qu
Zhenjun Wang
Jiagang Han
Publikationsdatum
18.06.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
International Journal of Colorectal Disease / Ausgabe 7/2022
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-022-04179-7

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