pT3N0 rectal cancer: adjuvant CRT tops ACT for lower tumors

  • Peng HH & al.
  • Radiat Oncol
  • 16 Jan 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • In patients with pT3N0 rectal cancer, adjuvant chemoradiotherapy (CRT) was associated with better outcomes than adjuvant chemotherapy (ACT), but only in lower tumors.

Why this matters

  • Tumor location could help guide the choice between adjuvant CRT and ACT.
  • pT3N0 patients have a low rate of local recurrence after total mesorectal incision, leading to questions as to whether additional radiotherapy would be of benefit.

Study design

  • Retrospective analysis of 265 patients (115 undergoing adjuvant CRT [median follow-up, 56.4 months]; 150 receiving ACT [median follow-up, 57.1 months]) at Affiliated Cancer Hospital & Institute of Guangzhou Medical University.
  • Funding: None.

Key results

  • Among patients with lower tumors, adjuvant CRT was associated with:
    • Longer DFS than ACT: 87.43% vs 70.56% (P=.015), but not OS.
    • Lower rate of distant metastasis (5 years: 8.6% vs 22.2%; P=.033).
  • Among patients with upper tumor, there were no significant differences in outcomes between the 2 treatment groups.

Limitations

  • Retrospective, single-center.

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