Hypofractionated Preoperative Chemoradiotherapy In Locally Advanced Rectal Cancer: Preliminary Results

Abstract

OBJECTIVEThe aim of the present study was to evaluate the efficacy and safety of preoperative hypofractionatedchemoradiotherapy in our patients with locally advanced rectum cancer, which was previously observedin the Far East (KROG 11-02).METHODSTwenty-seven patients with locally advanced rectal cancer (cT3-4N0-2M0) between November 2014and August 2016 were included in the study. A 2-week schedule of hypofractionated radiotherapy, 33Gy/10 fractions, with concurrent 1 cycle of oral capecitabine (1650 mg/m2/day) was applied. Patientswere planned to undergo surgery 6–8 weeks after the completion of chemoradiotherapy. End pointswere tumor responses and toxicity.RESULTSAll patients underwent total mesorectal excision except for only 1 patient, and statistical analysis wasperformed on 26 patients. Of the 27 patients, 10 (38.4%) were downstaged, and 3 (11.5%) had a pathologically complete response. No grade 3–4 toxicity was observed in the patient group. Grade 1–2 hematologic toxicity developed in 2 (8%) patients, and no biochemical abnormality was observed. Gastrointestinal toxicity was observed in 17 (65%), genitourinary toxicity in 8 (30%), and radiodermatitis in 3(11%) patients. One patient had permanent anastomosis and wound dehiscence, and presacral abscesswas also seen in one patient. Enterocutaneous fistula developed in only one patient.CONCLUSIONA 2-week schedule of radiotherapy with oral capecitabine in patients with locally advanced rectal cancerresulted in similar toxicity levels and tumor response rate in comparison with previous results.