Is long interval from neoadjuvant chemoradiotherapy to surgery optimal for rectal cancer in the era of intensity-modulated radiotherapy?: A prospective observational study

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Abstract

Objectives: To evaluate the impact of interval between neoadjuvant chemoradiotherapy (NACRT) and surgery on therapeutic and adverse effects of surgery, and long-term outcome of patients with locally advanced rectal cancer (RC), in the era of intensity-modulated radiotherapy (IMRT). Patients and methods: Patients diagnosed with stage II–III RC and treated with IMRT-based NACRT followed by radical surgery were enrolled consecutively from April 2011 to March 2014. The data of all the patients were collected prospectively and grouped according to their NACRT-to-surgery interval. The therapeutic and adverse effects of surgery, and survivals were compared between the patients with interval #7 weeks and those with interval $8 weeks. Results: A total of 231 patients were eligible for analysis, including 106 cases with interval #7 weeks and 125 cases with interval $8 weeks. The therapeutic and adverse effects of surgery were similar between these two groups of patients. However, interval $8 weeks appeared to lead to poorer overall, distant-metastasis-free and disease-free survivals, compared with interval #7 weeks. The HRs were 1.805, 1.714, and 1.796 (P-values were 0.045, 0.049, and 0.028), respectively. Conclusion: For patients with locally advanced RC, a long NACRT-to-surgery interval might bring a potential risk of increased distant metastasis rather than a better tumor regression in the era of IMRT.

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Chang, H., Jiang, W., Ye, W. J., Tao, Y. L., Wang, Q. X., Xiao, W. W., & Gao, Y. H. (2018). Is long interval from neoadjuvant chemoradiotherapy to surgery optimal for rectal cancer in the era of intensity-modulated radiotherapy?: A prospective observational study. OncoTargets and Therapy, 11, 6129–6138. https://doi.org/10.2147/OTT.S169985

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