Publication: Neoadjuvant chemotherapy without radiation therapy for rectal cancer with negative prognosis
Дата
2022
Авторы
Belohvostova, A. S.
Mihaleva, Y. Yu.
Pochuev, T. P.
Berezovskaya, T. P.
Nevolskikh, A. A.
Avdeenko, V. A.
Zibirov, R. F.
Ivanov, S. A.
Journal Title
Journal ISSN
Volume Title
Издатель
Аннотация
© 2022, Association of Coloproctologists of Russia. All rights reserved.AIM: to assess the effectiveness of neo-CT in the FOLFOX6 regimen in patients with mid-and upper rectal cancer (RC) associated with poor prognosis. PATIENTS AND METHODS: fifty-two patients were included into study. All had neo-CT with subsequent surgical treatment between 2017 and 2021. Of them 94.2% had stage I I I and 5.8% had stage II. An extramural vascular invasion was detected by MRI in 33 (63.5%) patients. The distance between the tumor and the mesorectal fascia was ≤ 2 mm in 17%. All patients had 4 cycles of neo-CT in FOLFOX6 regimen followed by surgery. RESULTS: the compliance (≥ 4 cycles of neo-CT) was 82.7% (n = 43). The overall toxicity rate was 35.6%. Sphincter-saving surgery was performed in 51 (98.1%) patients. Postoperative morbidity was 25.0%. Final pathology revealed stage I I I in 29 (55.8%) patients, stage 0 — stage I I — in 22 (42.3%). In accordance with the degree of patho-morphosis (CAP, 2019), 12 (23.1%) patients showed a partial response. In one patient (1.9%) no signs of residual tumor were detected. Down staging of the Tstage compared with M RI data before neo-CT was noted in 23 (44.2%) patients, N stage — in 29 (55.8%). With a mean follow-up of 31 (3-54) months, local recurrences were detected in 5 (9.6%) patients, and distant metastases in 4 (7.7%). The cumulative 3-year recurrence rate was 11.3 ± 4.8%. The three-year overall and recurrence-free survival rate was 88.2 ± 5.8% and 76.4 ± 7.4%, respectively. CONCLUSION: the multimodal approach for RC with adverse prognostic factors using neo-CT in the FOLFOX6 regimen is well tolerated by patients, has a small toxicity and postoperative morbidity as well. It is necessary to develop new pathology criteria for tumor response to neo-CT.
Описание
Ключевые слова
Цитирование
Neoadjuvant chemotherapy without radiation therapy for rectal cancer with negative prognosis / Belohvostova, A.S. [et al.] // Koloproktologia. - 2022. - 21. - № 2. - P. 91-104. - 10.33878/2073-7556-2022-21-2-91-104