Hypofractionated Preoperative Chemoradiotherapy In Locally Advanced Rectal Cancer: Preliminary Results

Abstract

OBJECTIVE The aim of the present study was to evaluate the efficacy and safety of preoperative hypofractionated chemoradiotherapy in our patients with locally advanced rectum cancer, which was previously observed in the Far East (KROG 11-02). METHODS Twenty-seven patients with locally advanced rectal cancer (cT3-4N0-2M0) between November 2014 and August 2016 were included in the study. A 2-week schedule of hypofractionated radiotherapy, 33 Gy/10 fractions, with concurrent 1 cycle of oral capecitabine (1650 mg/m2/day) was applied. Patients were planned to undergo surgery 6-8 weeks after the completion of chemoradiotherapy. End points were tumor responses and toxicity. RESULTS All patients underwent total mesorectal excision except for only 1 patient, and statistical analysis was performed 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 abscess was also seen in one patient. Enterocutaneous fistula developed in only one patient. CONCLUSION A 2-week schedule of radiotherapy with oral capecitabine in patients with locally advanced rectal cancer resulted in similar toxicity levels and tumor response rate in comparison with previous results.