Efficacy and Safety of Different Radiotherapy Doses in Neoadjuvant Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer: A Retrospective Study

Overview

Journal Front Oncol

Specialty Oncology

Date 2023 Mar 10

PMID 36895482

Authors

Yuyan Xu

Haizhou Zou

Zhenyong Shao

Xuebang Zhang

Xiaolin Ren

Huijuan He

Dahai Zhang

Dexi Du

Changlin Zou

Affiliations

Soon will be listed here.

Abstract

Background: This study aims to compare the efficacy and safety of neoadjuvant chemoradiotherapy (nCRT) with different radiotherapy doses (45Gy and 50.4Gy) in patients with locally advanced rectal cancer (LARC).

Methods: Herein, 120 patients with LARC were retrospectively enrolled between January 2016 and June 2021. All patients underwent two courses of induction chemotherapy (XELOX), chemoradiotherapy, and total mesorectum excision (TME). A total of 72 patients received a radiotherapy dose of 50.4 Gy, while 48 patients received a dose of 45 Gy. Surgery was then performed within 5-12 weeks following nCRT.

Results: There was no statistically significant difference between the baseline characteristics of the two groups. The rate of good pathological response in the 50.4Gy group was 59.72% (43/72), while in the 45Gy group achieved 64.58% (31/48) (P>0.05). The disease control rate (DCR) in the 50.4Gy group was 88.89% (64/72), compared to 89.58% (43/48) in the 45Gy group (P>0.05). The incidence of adverse reactions for radioactive proctitis, myelosuppression, and intestinal obstruction or perforation differed significantly between the two groups (P<0.05). The anal retention rate in the 50.4Gy group was significantly higher in contrast to the 45Gy group (P<0.05).

Conclusions: Patients receiving a radiotherapy dose of 50.4Gy have a better anal retention rate but also a higher incidence of adverse events such as radioactive proctitis, myelosuppression, and intestinal obstruction or perforation, and a comparable prognosis to patients treated with a radiotherapy dose of 45Gy.

Citing Articles

Short- and long-term outcomes of neoadjuvant chemotherapy compared with neoadjuvant chemoradiotherapy for locally advanced rectal cancer: an updated meta-analysis.

Guo Y, Guo Z, Zhang J, Qian G, Ji W, Song L BMC Gastroenterol. 2025; 25(1):87.

PMID: 39962374 PMC: 11834637. DOI: 10.1186/s12876-025-03667-8.

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