1
|
Gordeyev S, Ivanov V, Fedianin M, Chernikh M, Kozlov N, Petrov L, Erygin D, Gridasov I, Kaushanskiy V, Feoktistov D, Mamedli Z. Neoadjuvant chemoradiotherapy for locally advanced rectal cancer with peritumoral abscesses and fistulas. Strahlenther Onkol 2021; 198:201-208. [PMID: 34825253 DOI: 10.1007/s00066-021-01878-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/01/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Rectal cancer patients who present with peritumoral abscesses and fistulas at the time of diagnosis may be denied chemoradiotherapy (CRT) as the safety is unknown. The aim of this study was to investigate the safety of preoperative CRT in this patient group. METHODS We performed a retrospective nested case-control study to compare outcomes between patients with locally advanced rectal cancer with peritumoral abscesses and fistulas (study group) and patients with T4 locally advanced rectal cancer with no evidence of abscesses and fistulas (control group). These groups were matched by treatment center and radiotherapy delivery method. All patients received 50-54 Gy of conventionally fractionated RT with concurrent chemotherapy. Primary endpoint was grade 3-5 toxicity (by National Cancer Institute Common Toxicity Criteria for Adverse Events (NCI CTCAE). Secondary endpoints included postoperative morbidity, pathologic complete response (pCR), disease-free survival (DFS), and overall survival (OS) at 2 years. RESULTS A total of 33 patients were included in each group. Grade 3 toxicity was observed in 2 (6.1%) patients in the study group and 4 (12.1%) patients in the control group (p = 0.672). No patients developed grade 4-5 toxicity. Grade 3-4 Clavien-Dindo complications were observed in 5 (15.2%) patients in the study group and in 6 (18.2%) patients in the control group (p = 1.0). Pathologic CR was achieved in 3 (9.1%) and 5 (15.2%) patients, respectively (p = 0.708). Two-year OS was 78.3% vs. 81.8% (p = 0.944), 2‑year DFS was 62.8% vs. 69.7% (p = 0.693), respectively. CONCLUSION The presence of peritumoral abscesses and fistulas in patients with locally advanced rectal cancer is not associated with increased toxicity or inferior clinical outcomes after preoperative CRT.
Collapse
Affiliation(s)
- Sergey Gordeyev
- N.N.Blokhin National Medical Research Center of Oncology, 23, Kashirskoe shosse, 115478, Moscow, Russian Federation.
| | - Valerii Ivanov
- "PET-technology" cancer center, 26, 50 let VLKSM st., 142110, Podolsk, Russian Federation
| | - Mikhail Fedianin
- N.N.Blokhin National Medical Research Center of Oncology, 23, Kashirskoe shosse, 115478, Moscow, Russian Federation.,Department of oncology and hematology at medical faculty of the Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
| | - Marina Chernikh
- N.N.Blokhin National Medical Research Center of Oncology, 23, Kashirskoe shosse, 115478, Moscow, Russian Federation.,"PET-technology" cancer center, 26, 50 let VLKSM st., 142110, Podolsk, Russian Federation.,I.M.Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Nikolay Kozlov
- N.N.Blokhin National Medical Research Center of Oncology, 23, Kashirskoe shosse, 115478, Moscow, Russian Federation
| | - Leonid Petrov
- A.F. Tsyb Medical Radiological Research Center, Zhukov st., 249031, Obninsk, Russian Federation
| | - Dmitriy Erygin
- Moscow city oncological hospital № 1, Baumanskaya 17/1, 105005, Moscow, Russian Federation
| | - Ivan Gridasov
- Stavropol regional oncological dispensary, 182A, Oktyabrskaya st., 355047, Stavropol, Russian Federation
| | - Valery Kaushanskiy
- Krasnodar regional oncological dispensary, 146, Dmitrova st., 350040, Krasnodar, Russian Federation
| | - Dmitry Feoktistov
- Bashkir regional oncological dispensary, 73/1, Prospekt Octyabrya, 450054, Ufa, Russian Federation
| | - Zaman Mamedli
- N.N.Blokhin National Medical Research Center of Oncology, 23, Kashirskoe shosse, 115478, Moscow, Russian Federation
| |
Collapse
|