Gastrointestinal Cancer

PV 04 - Poster Viewing Q&A - Session 4

TU_5_2409 - Long Term Efficacy of Preoperative Chemotherapy or Chemoradiotherapy Combined with Total Mesorectal Excision for Locally Advanced Rectal Cancer: Retrospectiveanalysis of 305 Patients

Tuesday, September 17
2:45 PM - 4:00 PM
Location: ASTRO Innovation Hub

Long Term Efficacy of Preoperative Chemotherapy or Chemoradiotherapy Combined with Total Mesorectal Excision for Locally Advanced Rectal Cancer: Retrospectiveanalysis of 305 Patients
M. Abulimiti1, J. Jin2, W. Liu Jr3, S. Li4, Y. Tang2, N. Li3, Y. Tang3, S. Wang3, Y. Song3, Y. Liu2, H. Fang3, N. Lu2, S. Qi5, B. Chen2, and Y. LI2; 1Department of Radiation Oncology,National Cancer Center/Cancer Hospital,Chinese Academy of Medical Scicences and Peking Union Medical College,, Beijing, China, 2Department of Radiation Oncology, National Cancer Center/Cancer Hospital and Institute, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China, 3National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, 4Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, China, 5Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

Purpose/Objective(s): To retrospectively analyze the long—term efficacy and prognostic factors of preoperative chemotherapy or chemoradiotherapy combined with total mesorectal excision (TME) in locally advanced rectal cancer.

Materials/Methods: A total of 305 patients who were consecutively admitted to our hospital and diagnosed with locally advanced rectal adenocarcinoma by pelvic magnetic resonance imaging or computed tomography from January 2006 to November 2018 were enrolled as subjects. 59 patients received preoperative chemotherapy with oxaliplatin+fluorouracil±irinotecan±leucovorin for 2-6 cycles, and then TME(R0 excision) at 2-8weeks (median time=3.75 weeks), 246 patients received preoperative radiotherapy with dose ranging from 42.0 to 50.4Gy (median dose =50Gy) and concurrent chemotherapy with capecitabine ± oxaliplatinand then TME(R0 excision) at 4-15 weeks (median time=7 weeks). Postoperative radiotherapy or chemotherapy were given according to the individual pathological stages and recovery. Disease free survival(DFS),locoregional recurrence(LRR),overall survival(OS) and distant metastasis (DM) rates were calculated by the Kaplan—Meier method and analyzed by the log—rank test.

Results: In all, 305 patients aged 18-82 (median age 55).Other basic information of the patients is as shown in the table , The median follow-up time was 38 months and the 3-year LRR, DM, DFS and OS were 4.5%, 23.3%, 77% and 87.3% respectively. In the preoperative chemotherapy group, 3-year LRR, DM, DFS and OS were 5%, 16.7%, 86.3% and 89.1%, respectively meanwhile, the 3-year LRR, DM, DFS and OS in the preoperative chemoradiotherapy group were 4.4%, 24.8%, 75.6% and 85.7%, with no statistical significance between two groups (P > 0.05). R0 resection rate and pCR rate in Preoperative chemotherapy group and chemoradiotherapy group were: 96.7% and 100%, 3.4% and 13.7% respectively, There were significant differences in PCR rates.

Conclusion: Similar efficacy was acquired by preoperative chemotherapyand chemoradiotherapyin LARC, when patients received preoperative chemotherapy with tumor mainly located in the middle and upper. Besides, the other critical factors in the strategy design for rectal cancer such as MRF, EMVI should be further evaluated between these two arms. Table:The baseline information of the patients
In total Preoperative chemotherapy preoperative chemoradiotherapy P value
Age
>65 66(21.6%) 12(22%) 53(21.5%) 0.93
≤65 239(78.4%) 46(78%) 193(78.5%)
Sex
male 207(67.8%) 37(62.7%) 170(69.1%) 0.10
female 98(32.2%) 22(37.3%) 76(30.9%)
Tumor location
Upper Rectum 20(6.6%) 20(34%) 0 <0.001
Middle Rectum 96(31.4%) 25(42.4%) 71(28%)
Lower Rectum 189(62%) 14(23.7%) 175(72%)
Stage
II(T3-4N0-1) 53(17.4%) 7(11.9%) 46(18.7%) 0.052
III 251(82.3%) 51(86.4%) 200(81.3%)
IV 1(0.3%) 1(1.7%) 0

Author Disclosure: M. Abulimiti: None. J. Jin: None. S. Li: None. Y. Tang: None.

Muyasha Abulimiti, dr

National Clinical Research Center for Cancer/Cancer Hospital

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TU_5_2409 - Long Term Efficacy of Preoperative Chemotherapy or Chemoradiotherapy Combined with Total Mesorectal Excision for Locally Advanced Rectal Cancer: Retrospectiveanalysis of 305 Patients



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