Neoadjuvant chemoradiotherapy for locally advanced rectal cancer with peritumoral abscesses and fistulas

Gordeev, S. S.; Иванов, В. А.; Федянин, М. Ю.; Chernikh, Marina; Козлов, Н. А.; Петров, Л. О.; Erygin, D. V.; Gridasov, I.M.; Kaushanskiy, V. B.; Feoktistov, Dmitriy; Мамедли, З. З.

doi:10.1007/s00066-021-01878-y

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…Nowadays, even a peritumoral abscess or fistula is no longer an absolute contraindication for RCT. These patients can be safely offered nRCT without an increase in toxicity and with the same pCR-rate, OS, and DFS [32].…”

Section: Discussionmentioning

confidence: 87%

Preoperative Radiochemotherapy in Rectal Cancer: Is There an Impact of Oxaliplatin on Pathologic Complete Response and Survival Rates under “Real World“ Conditions?

Grabenbauer

Aigner

Göbel

et al. 2023

Cells

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This study aimed to evaluate the benefit of additional administration of oxaliplatin during fluorouracil-based neoadjuvant radiochemotherapy (nRCT) in terms of pathologic complete remission (pCR), disease-free survival (DFS), and overall survival (OS) in patients with advanced rectal cancer. Between 2006 and 2021, 669 patients (pts) were diagnosed with locally advanced rectal cancer, of whom a total of 414 pts with nRCT were identified and included in the study. A total of 283 pts were treated by nRCT using concurrent chemotherapy with fluorouracil or capecitabine; 131 pts were treated using a combination of fluorouracil or capecitabine and oxaliplatin. Propensity score matching analyses (PSM) with 114 pts in each group were used to balance the patients’ characteristics. OS, DFS, pCR-rate, and potential prognostic factors were compared between the two groups. The median follow-up time was 59.5 weeks in the fluorouracil-group and 43 weeks in the fluorouracil/oxaliplatin group (p = 0.003). After PSM, the pCR-rate (including sustained clinical complete remission) was 27% (31/114 pts) in the fluorouracil/oxaliplatin group and 16% (18/114 pts) in the fluorouracil-group (p = 0.033). There was no difference between these two groups for both 10-year OS and DFS neither before nor after PSM, respectively (OS: 72.6% vs. 55.4%, p = 0.066, and 67.8% vs. 55.1%, p = 0.703, and DFS: 44.8% vs. 46.8%, p = 0.134, and 44.7% vs. 42.3%, p = 0.184). Multivariate analysis identified regression grading according to Dworak grade 4 (HR: 0.659; CI: 0.471–0.921; p = 0.015) and age over 60 years (HR: 2.231; CI: 1.245–4.001; p = 0.007) as independent predictors for OS. In conclusion, the addition of oxaliplatin to fluorouracil during nRCT significantly improved pCR-rate without having an impact on survival.

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Section: Discussionmentioning

confidence: 87%

Preoperative Radiochemotherapy in Rectal Cancer: Is There an Impact of Oxaliplatin on Pathologic Complete Response and Survival Rates under “Real World“ Conditions?

Grabenbauer

Aigner

Göbel

et al. 2023

Cells

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“…CRT may aggravate infection when abscesses are present and may not be fully effective when patients have increased inflammation. Gordeyev, S et al reported that the presence of perirectal abscesses and fistulas in patients with locally advanced rectal cancer were not associated with increased toxicity or inferior clinical outcomes after preoperative CRT [ 19 ]. However, 22 of the 33 patients (66.7 %) had a colostomy created prior to CRT to control infection before CRT.…”

Section: Discussionmentioning

confidence: 99%

Successful resection of rectal cancer and perirectal abscess following systemic chemotherapy and chemoradiotherapy: A case report

Yano

Nakano

Yoshimitsu

et al. 2023

International Journal of Surgery Case Reports

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The addition of paclitaxel in chemoradiotherapy of anal squamous cell carcinoma: a prospective randomized phase 3 trial

et al. 2022

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AIM: to compare long-term outcomes and safety of the addition of paclitaxel to chemoradiotherapy for squamous cell anal carcinoma.PATIENTS AND METHODS: A prospective phase 3 randomized trial included patients with histologically verified non-metastatic anal squamous cell carcinoma. Patients received radiotherapy 52-54 Gy (for T1-T2 tumors) and 56-58 Gy (for T3- T4 tumors) in 2 Gy daily fractions during chemotherapy with mitomycin C (10 mg/m2 i.v. day 1), capecitabine (625 mg/m2 2 times a day orally on days of radiation therapy), paclitaxel (45 mg/m2 i.v. on days 3, 10 , 17, 24, 31) during 2013-2019. In the control group patients received a similar course of RT and chemotherapy with mitomycin C (12 mg/m2 i.v. day 1 ), capecitabine (825 mg/m2 2 times a day orally on radiotherapy days). The primary endpoint was 3-year disease-free survival (DFS). Secondary endpoints included complication rate (NCI-CTCAE 4.0), complete clinical response rate at 12 weeks and 26 weeks after completion of CRT, and 3-year overall survival (OS).RESULTS: The study and control groups included 72 patients each. The median follow-up was 39.5 months. A complete clinical response at the 26-week follow-up was recorded in 64 (88.9%) patients in the study group and in 54 (75%) patients in the control group (p=0.049). There were no differences in the incidence of complications of grades 3-4 in the two groups (39/72 [54.2%] in the study group versus 35/72 [48.6%] in the control group (p=0.617)). Three-year progression-free survival in the study group was 87.1%, in the control group - 64.4% (p=0.001). Three-year overall survival in the study group was 95.5%, in the control group - 80.0% (p<0.001).CONCLUSION: CRT with paclitaxel for squamous cell anal carcinoma has acceptable toxicity and may improve long-term treatment outcomes.

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Neoadjuvant chemoradiotherapy for locally advanced rectal cancer with peritumoral abscesses and fistulas

Cited by 3 publications

References 11 publications

Preoperative Radiochemotherapy in Rectal Cancer: Is There an Impact of Oxaliplatin on Pathologic Complete Response and Survival Rates under “Real World“ Conditions?

Preoperative Radiochemotherapy in Rectal Cancer: Is There an Impact of Oxaliplatin on Pathologic Complete Response and Survival Rates under “Real World“ Conditions?

Successful resection of rectal cancer and perirectal abscess following systemic chemotherapy and chemoradiotherapy: A case report

The addition of paclitaxel in chemoradiotherapy of anal squamous cell carcinoma: a prospective randomized phase 3 trial

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