Clinical and Translational Radiation Oncology (Jun 2017)
Time to surgery and pathologic complete response after neoadjuvant chemoradiation in rectal cancer: A population study on 2094 patients
- Gabriella Macchia,
- Maria Antonietta Gambacorta,
- Carlotta Masciocchi,
- Giuditta Chiloiro,
- Giovanna Mantello,
- Maika di Benedetto,
- Marco Lupattelli,
- Elisa Palazzari,
- Liliana Belgioia,
- Almalina Bacigalupo,
- Aldo Sainato,
- Sabrina Montrone,
- Lucia Turri,
- Angela Caroli,
- Antonino De Paoli,
- Fabio Matrone,
- Carlo Capirci,
- Giampaolo Montesi,
- Rita Marina Niespolo,
- Mattia Falchetto Osti,
- Luciana Caravatta,
- Alessandra Galardi,
- Domenico Genovesi,
- Maria Elena Rosetto,
- Caterina Boso,
- Piera Sciacero,
- Lucia Giaccherini,
- Salvatore Parisi,
- Antonella Fontana,
- Francesco Romeo Filippone,
- Vincenzo Picardi,
- Alessio Giuseppe Morganti,
- Vincenzo Valentini
Affiliations
- Gabriella Macchia
- Radiotherapy Unit, Fondazione di Ricerca e Cura “Giovanni Paolo II”, Università Cattolica S. Cuore, Campobasso, Italy
- Maria Antonietta Gambacorta
- Department of Radiotherapy, Fondazione “Policlinico Gemelli”, Università Cattolica S. Cuore, Roma, Italy
- Carlotta Masciocchi
- Department of Radiotherapy, Fondazione “Policlinico Gemelli”, Università Cattolica S. Cuore, Roma, Italy
- Giuditta Chiloiro
- Department of Radiotherapy, Fondazione “Policlinico Gemelli”, Università Cattolica S. Cuore, Roma, Italy
- Giovanna Mantello
- Radiotherapy Unit, Azienda Ospedaliero Universitaria, Ospedali Riuniti Ancona, Italy
- Maika di Benedetto
- Radiotherapy Unit, Azienda Ospedaliero Universitaria, Ospedali Riuniti Ancona, Italy
- Marco Lupattelli
- Radiotherapy Unit, ‘S. Maria della Misericordia’ Hospital, Perugia, Italy
- Elisa Palazzari
- Radiotherapy Unit, ‘S. Maria della Misericordia’ Hospital, Perugia, Italy
- Liliana Belgioia
- Radiotherapy Unit, AOU IRCCS San Martino, IST National Cancer Research Institute, Genova, Italy
- Almalina Bacigalupo
- Radiotherapy Unit, AOU IRCCS San Martino, IST National Cancer Research Institute, Genova, Italy
- Aldo Sainato
- Radiotherapy Unit, University Hospital, Pisa, Italy
- Sabrina Montrone
- Radiotherapy Unit, University Hospital, Pisa, Italy
- Lucia Turri
- Radiotherapy Unit, ‘Maggiore della Carità’ Hospital, Novara, Italy
- Angela Caroli
- Radiotherapy Unit, ‘Maggiore della Carità’ Hospital, Novara, Italy
- Antonino De Paoli
- Radiation Oncology Department, Oncological Referral Center, Aviano, Italy
- Fabio Matrone
- Radiation Oncology Department, Oncological Referral Center, Aviano, Italy
- Carlo Capirci
- Radiotherapy Unit, ULSS18, Rovigo, Italy
- Giampaolo Montesi
- Radiotherapy Unit, ULSS18, Rovigo, Italy
- Rita Marina Niespolo
- Radiotherapy Unit, “S. Gerardo” Hospital, Monza, Italy
- Mattia Falchetto Osti
- Department of Radiation Oncology, Facoltà di Medicina e Psicologia, Università Sapienza, Roma, Italy
- Luciana Caravatta
- Radiation Oncology Department, ‘A. Businco’ Regional Oncological Hospital, Cagliari, Italy
- Alessandra Galardi
- Department of Radiotherapy, University Hospital, Firenze, Italy
- Domenico Genovesi
- Radiotherapy Unit, ‘SS Annunziata’ Hospital, ‘G.D'Annunzio’ University, Chieti, Italy
- Maria Elena Rosetto
- Radiotherapy Unit, “Belcolle” Hospital, Viterbo, Italy
- Caterina Boso
- Radiotherapy and Nuclear Medicine Unit, Veneto Institute of Oncology-IRCCS, Padova, Italy
- Piera Sciacero
- Radiotherapy Unit, ASL TO4, General Hospital, Ivrea, Italy
- Lucia Giaccherini
- Radiation Oncology Center, Department of Experimental, Diagnostic and Speciality Medicine-DIMES-University of Bologna, S. Orsola-Malpighi Hospital, Italy
- Salvatore Parisi
- Radiotherapy Unit, Casa Sollievo della Sofferenza, IRCCS-CSS San Giovanni Rotondo, Italy
- Antonella Fontana
- Radiotherapy Unit, “S.M. Goretti” Hospital Latina, Italy
- Francesco Romeo Filippone
- Radiotherapy Unit, Azienda ospedaliera Papa Giovanni XXIII, Bergamo, Italy
- Vincenzo Picardi
- Radiotherapy Unit, Fondazione di Ricerca e Cura “Giovanni Paolo II”, Università Cattolica S. Cuore, Campobasso, Italy
- Alessio Giuseppe Morganti
- Radiation Oncology Center, Department of Experimental, Diagnostic and Speciality Medicine-DIMES-University of Bologna, S. Orsola-Malpighi Hospital, Italy
- Vincenzo Valentini
- Department of Radiotherapy, Fondazione “Policlinico Gemelli”, Università Cattolica S. Cuore, Roma, Italy
- DOI
- https://doi.org/10.1016/j.ctro.2017.04.004
- Journal volume & issue
-
Vol. 4,
no. C
pp. 8 – 14
Abstract
Background: To retrospectively evaluate the difference in terms of pathologic complete response (pCR) according to time elapsed between chemoradiation (CRT) and total mesorectal excision (TME) on a large unselected real-life dataset of locally advanced rectal cancer (LARC) patients. Methods: A multicentre retrospective cohort study of LARC patients from 21 Italian Radiotherapy Institutions was performed. Patients were stratified into 3 different time intervals from CRT. The 1st group included 300 patients who underwent TME within 6 weeks, the 2nd 1598 patients (TME within 7–12 weeks) and the 3rd 196 patients (TME within 13 or more weeks after CRT), respectively. Results: Data on 2094 LARC patients treated between 1997 and 2016 were considered suitable for analysis. Overall, 578 patients had stage II while 1516 had stage III histological proven invasive rectal adenocarcinoma. A CRT schedule of one agent (N = 1585) or 2-drugs (N = 509) was administered. Overall, pCR was 22.3% (N = 468 patients). The proportion of patients achieving pCR with respect to time interval was, as follows: 12.6% (1st group), 23% (2nd group) and 31.1% (3rd group) (p 5040 cGy (p = 0.002) and longer interval (p 13 weeks) from CRT to surgery improves the pathological response (pCR and pathologic partial response; pPR) in comparison to historic data. Furthermore, radiotherapy dose >5040 cGy and two drugs chemotherapy correlated with pPR rate.
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