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Showing content from https://pubmed.ncbi.nlm.nih.gov/32103755/ below:

Neoadjuvant radiotherapy improves overall survival for T3/4N+M0 rectal cancer patients: a population-based study of 20300 patients

Affiliations

• ¹ Department of Radiation Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, People's Republic of China. zju_zhaofeng@zju.edu.cn.
• ² Graduate School, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, People's Republic of China.
• ³ Department of Colorectal Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, People's Republic of China.
• ⁴ Department of Radiation Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, People's Republic of China.
• ⁵ Institute of Pharmaceutical Biotechnology and The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, People's Republic of China.
• ⁶ Department of Radiation Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, People's Republic of China. yansenxiang@zju.edu.cn.

• PMID: 32103755
• PMCID: PMC7045410
• DOI: 10.1186/s13014-020-01497-4

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Feng Zhao et al. Radiat Oncol. 2020.

• ¹ Department of Radiation Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, People's Republic of China. zju_zhaofeng@zju.edu.cn.
• ² Graduate School, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, People's Republic of China.
• ³ Department of Colorectal Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, People's Republic of China.
• ⁴ Department of Radiation Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, People's Republic of China.
• ⁵ Institute of Pharmaceutical Biotechnology and The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, People's Republic of China.
• ⁶ Department of Radiation Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, People's Republic of China. yansenxiang@zju.edu.cn.

• PMID: 32103755
• PMCID: PMC7045410
• DOI: 10.1186/s13014-020-01497-4

Item in Clipboard

Background: Neoadjuvant radiotherapy (RT) has been shown to improve local control; however, whether it can improve overall survival (OS) in locally advanced rectal cancer (LARC) patients remains controversial. We therefore aimed to examine the benefits of surgery alone, neoadjuvant radiotherapy (RT), adjuvant RT, and surgery plus chemotherapy in stage II (T3/4N0M0) and III (any T and N + M0) on the OS of rectal cancer patients.

Methods: Date from the Surveillance, Epidemiology, and End Results (SEER) database diagnosed between 2004 and 2016 were used. Kaplan-Meier analyses were used to compare patient prognoses across different treatment modalities. Cox hazard regression analysis were used to identify independent predictors of OS.

Results: For stage T3/4N0M0 patients, neoadjuvant RT, adjuvant RT, and surgery plus chemotherapy resulted in similar OS (all p > 0.05; mean survival, 115.89 months (M), 111.97 M, and 117.22 M, respectively), with better OS observed in these patients than in patients who underwent surgery alone (all p < 0.001, mean survival, 88.96 M). For stage T1/2N + M0 patients, neoadjuvant RT, adjuvant RT, and surgery plus chemotherapy resulted in similar OS (all p > 0.05; mean survival, 121.50 M, 124.25 M, and 121.20 M, respectively), with better OS observed in these patients than in patients who underwent surgery alone (all p < 0.001, mean survival 83.81 M). For stage T3/4N + M0 patients, neoadjuvant RT (HR = 0.436; 95% CI, 0.396~0.478; p < 0.001) resulted in significantly longer OS than adjuvant RT and surgery plus chemotherapy (mean survival, 104.47 M, 93.94 M, and 93.62 M, respectively), with better OS observed in these patients than in patients who underwent surgery alone (all p < 0.001, mean survival 54.87 M). Older age (> 60 years), black race, unmarried status, high tumour grade, and tumour size > 5 cm were all associated with a poor prognosis (all p < 0.05).

Conclusions: Neoadjuvant RT, adjuvant RT, and surgery plus chemotherapy results in better OS than surgery alone in LARC patients. Neoadjuvant RT has the potential to be highly recommended over adjuvant RT and surgery plus chemotherapy for T3/4N + M0 patients; however, it showed no OS advantage over adjuvant RT or surgery plus chemotherapy for T3/4N0M0 and T1/2N + M0 patients.

Keywords: Chemotherapy; Overall survival (OS); Radiotherapy (RT); Rectal cancer; Surgery.

PubMed Disclaimer

The authors declare that they have no competing interests.

Flow chart for the creation…

Flow chart for the creation of the patient cohort data set

Flow chart for the creation of the patient cohort data set

OS estimated with the Kaplan-Meier…

OS estimated with the Kaplan-Meier method for stage II and III rectal cancer.…

OS estimated with the Kaplan-Meier method for stage II and III rectal cancer. a OS estimated with the Kaplan-Meier method for patients with T_3/4N₀M₀ stage disease receiving different treatment modalities (surgery alone versus (vs.) adjuvant RT: p < 0.001; surgery alone vs. neoadjuvant RT: p < 0.001; surgery alone vs. surgery plus chemotherapy: p < 0.001; adjuvant RT vs. neoadjuvant RT: p = 0.051; adjuvant RT vs. surgery plus chemotherapy: p = 0.214; and neoadjuvant RT vs. surgery plus chemotherapy: p = 0.724). b OS estimated with the Kaplan-Meier method for patients with T_1/2N₊M₀ stage disease receiving different treatment modalities (surgery alone vs. adjuvant RT: p < 0.001; surgery alone vs. neoadjuvant RT: p < 0.001; surgery alone vs. surgery plus chemotherapy: p < 0.001; adjuvant RT vs. neoadjuvant RT: p = 0.332; adjuvant RT vs. surgery plus chemotherapy: p = 0.442; and neoadjuvant RT vs. surgery plus chemotherapy: p = 0.906); c OS estimated with the Kaplan-Meier method for patients with T_3/4N₊M₀ stage disease receiving different treatment modalities (surgery alone vs. adjuvant RT: p < 0.001; surgery alone vs. neoadjuvant RT: p < 0.001; surgery alone vs. surgery plus chemotherapy: p < 0.001; adjuvant RT vs. neoadjuvant RT: p < 0.001; adjuvant RT vs. surgery plus chemotherapy: p = 0.637; and neoadjuvant RT vs. surgery plus chemotherapy: p < 0.001)

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  Wang D, Liu C, Zhou Y, Yan T, Li C, Yang Q, Xu Y, Zhao L, Pei Q, Tan F, Güngör C, Li Y. Wang D, et al. Radiat Oncol. 2020 May 13;15(1):107. doi: 10.1186/s13014-020-01561-z. Radiat Oncol. 2020. PMID: 32404114 Free PMC article.

• [Efficacy analysis of radiotherapy combined with surgery for locally advanced rectal mucinous adenocarcinoma: a retrospective study based on data of Surveillance, Epidemiology, and End results population].

  Zhang Y, Wang X, Chi P, Lin H, Lu X, Huang Y, Xu Z, Huang S, Sun Y, Ye D. Zhang Y, et al. Zhonghua Wei Chang Wai Ke Za Zhi. 2019 Jan 25;22(1):85-93. Zhonghua Wei Chang Wai Ke Za Zhi. 2019. PMID: 30703799 Chinese.

• Development and Assessment of a Clinical Calculator for Estimating the Likelihood of Recurrence and Survival Among Patients With Locally Advanced Rectal Cancer Treated With Chemotherapy, Radiotherapy, and Surgery.

  Weiser MR, Chou JF, Keshinro A, Chapman WC Jr, Bauer PS, Mutch MG, Parikh PJ, Cercek A, Saltz LB, Gollub MJ, Romesser PB, Crane CH, Shia J, Markowitz AJ, Garcia-Aguilar J, Gönen M; Colorectal Cancer Disease Management Team of Memorial Sloan Kettering Cancer Center. Weiser MR, et al. JAMA Netw Open. 2021 Nov 1;4(11):e2133457. doi: 10.1001/jamanetworkopen.2021.33457. JAMA Netw Open. 2021. PMID: 34748003 Free PMC article.

• Evaluation of Adjuvant Treatments for T1 N0 M0 Triple-Negative Breast Cancer.

  Zhai Z, Zheng Y, Yao J, Liu Y, Ruan J, Deng Y, Zhou L, Zhao P, Yang S, Hu J, We B, Wu Y, Zhang D, Kang H, Dai Z. Zhai Z, et al. JAMA Netw Open. 2020 Nov 2;3(11):e2021881. doi: 10.1001/jamanetworkopen.2020.21881. JAMA Netw Open. 2020. PMID: 33211105 Free PMC article.

• Can we eliminate neoadjuvant chemoradiotherapy in favor of neoadjuvant multiagent chemotherapy for select stage II/III rectal adenocarcinomas: Analysis of the National Cancer Data base.

  Cassidy RJ, Liu Y, Patel K, Zhong J, Steuer CE, Kooby DA, Russell MC, Gillespie TW, Landry JC. Cassidy RJ, et al. Cancer. 2017 Mar 1;123(5):783-793. doi: 10.1002/cncr.30410. Epub 2016 Oct 25. Cancer. 2017. PMID: 27780316 Free PMC article.

• Clinical development of MRI-based multi-sequence multi-regional radiomics model to predict lymph node metastasis in rectal cancer.

  Meng Y, Ai Q, Hu Y, Han H, Song C, Yuan G, Hou X, Weng W. Meng Y, et al. Abdom Radiol (NY). 2024 Jun;49(6):1805-1815. doi: 10.1007/s00261-024-04204-z. Epub 2024 Mar 10. Abdom Radiol (NY). 2024. PMID: 38462557

• Predicting pathological response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer with two step feature selection and ensemble learning.

  Qian C, Yang S, Chen Y, Ge R, Shi F, Liu C, Wang H, Guo Y. Qian C, et al. Sci Rep. 2025 Mar 22;15(1):9936. doi: 10.1038/s41598-025-94337-y. Sci Rep. 2025. PMID: 40121301 Free PMC article.

• Proteomic and metabolomic signatures of rectal tumor discriminate patients with different responses to preoperative radiotherapy.

  Wojakowska A, Marczak L, Zeman M, Chekan M, Zembala-Nożyńska E, Polanski K, Strugała A, Widlak P, Pietrowska M. Wojakowska A, et al. Front Oncol. 2024 Feb 12;14:1323961. doi: 10.3389/fonc.2024.1323961. eCollection 2024. Front Oncol. 2024. PMID: 38410100 Free PMC article.

• Effects of PreOperative radiotherapy in a preclinical glioblastoma model: a paradigm-shift approach.

  Fernandez-Gil BI, Schiapparelli P, Navarro-Garcia de Llano JP, Otamendi-Lopez A, Ulloa-Navas MJ, Michaelides L, Vazquez-Ramos CA, Herchko SM, Murray ME, Cherukuri Y, Asmann YW, Trifiletti DM, Quiñones-Hinojosa A. Fernandez-Gil BI, et al. J Neurooncol. 2024 Sep;169(3):633-646. doi: 10.1007/s11060-024-04765-5. Epub 2024 Jul 22. J Neurooncol. 2024. PMID: 39037687

• Protocol: The role of defunctioning stoma prior to neoadjuvant therapy for locally advanced colonic and rectal cancer-A systematic review.

  Mesri M, Hitchman L, Yiaesemidou M, Quyn A, Jayne D, Chetter I. Mesri M, et al. PLoS One. 2022 Sep 22;17(9):e0275025. doi: 10.1371/journal.pone.0275025. eCollection 2022. PLoS One. 2022. PMID: 36137109 Free PMC article.

1. 1. Siegel RL, Miller KD, Fedewa SA, Ahnen DJ, Meester R, Barzi A, Jemal A. Colorectal cancer statistics, 2017. CA Cancer J Clin. 2017;67(3):177–193. doi: 10.3322/caac.21395. - DOI - PubMed
2. 1. Song JH, Jeong JU, Lee JH, Kim SH, Cho HM, Um JW, Jang HS. Preoperative chemoradiotherapy versus postoperative chemoradiotherapy for stage II–III resectable rectal cancer: a meta-analysis of randomized controlled trials. Radiat Oncol J. 2017;35(3):198–207. doi: 10.3857/roj.2017.00059. - DOI - PMC - PubMed
3. 1. Li Y, Wang J, Ma X, Tan L, Yan Y, Xue C, Hui B, Liu R, Ma H, Ren J. A review of Neoadjuvant Chemoradiotherapy for locally advanced rectal Cancer. Int J Biol Sci. 2016;12(8):1022–1031. doi: 10.7150/ijbs.15438. - DOI - PMC - PubMed
4. 1. Cedermark B, Dahlberg M, Glimelius B, Pahlman L, Rutqvist LE, Wilking N. Improved survival with preoperative radiotherapy in resectable rectal cancer. N Engl J Med. 1997;336(14):980–987. doi: 10.1056/NEJM199704033361402. - DOI - PubMed
5. 1. Medical Research Council Rectal Cancer Working Party Randomised trial of surgery alone versus radiotherapy followed by surgery for potentially operable locally advanced rectal cancer. Lancet. 1996;348(9042):1605–1610. doi: 10.1016/S0140-6736(96)05348-2. - DOI - PubMed

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