In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 29, No. 4_suppl ( 2011-02-01), p. 537-537
Kurzfassung:
537 Background: The addition of concomitant chemotherapy to preoperative radiotherapy is standard of care for patients with T3-4 rectal cancer. The combined treatment modality increases the complete response rate and local control, but has no impact on survival or the incidence of distant metastases. Besides, it is associated with considerable toxicity. As an alternative strategy, we explored prospectively preoperative helical tomotherapy with a simultaneous integrated boost (SIB). Methods: 106 patients were treated with intensity-modulated and image-guided radiotherapy using the Tomotherapy Hi-Art II system. A dose of 46 Gy, in daily fractions of 2 Gy, was delivered to the mesorectum and draining lymph nodes, without concomitant chemotherapy. In patients with a circumferential resection margin (CRM) less than 2 mm on magnetic resonance imaging, a SIB was delivered to the tumor up to a total dose of 55.2 Gy. Acute and late side effects were scored using the NCI-CTC AE v. 3.0. Stage III patients received standard adjuvant chemotherapy. Results: 100 patients (94%) presented with a T3-4 tumor, of which 52 patients entered the boost group (CRM 〈 2 mm). 54 patients entered the no-boost group. One patient in the no-boost group developed a radiohypersensitivity reaction, resulting in a complete tumor remission, a grade 3 acute and grade 5 late enteritis. No other grade 3+ acute toxicities occurred. With a median follow-up of 32 months (range, 6-58), grade 3+ late gastrointestinal and urinary toxicity was observed in 7 patients (6%) and 4 patients (4%), respectively. Until yet, 2 locoregional relapses were observed. The actuarial 3-year local control, progression-free survival, and overall survival were 97%, 74% and 83%, respectively. Conclusions: Preoperative helical tomotherapy displays a favourable toxicity profile in patients with T3-4 rectal cancer. A SIB can be safely administered in patients with a narrow CRM and results in a promising local control. No significant financial relationships to disclose.
Materialart:
Online-Ressource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2011.29.4_suppl.537
Sprache:
Englisch
Verlag:
American Society of Clinical Oncology (ASCO)
Publikationsdatum:
2011
ZDB Id:
2005181-5
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