International Journal of Hematology and Oncology 2022, Vol 32, Num 3 Page(s): 174-181
Neoadjuvant Chemoradiotherapy in Rectal Cancer: A single Institution Experience from Turkey

Yasemin SENGUN1, Melek Gamze AKSU1, Rahmi Atil AKSOY1, Mine GENC1, Sema SEZGIN GOKSU2, Muhittin YAPRAK3, Aylin Fidan KORCUM1

1Akdeniz University, Faculty of Medicine, Department of Radiation Oncology, Antalya, TURKIYE
2Akdeniz University, Faculty of Medicine, Department of Medical Oncology, Antalya, TURKIYE
3Akdeniz University, Faculty of Medicine, Department of General Surgery, Antalya, TURKIYE

Keywords: Rectal cancer, Neoadjuvant treatment, Short-course radiotherapy, Long-course combined chemoradiation, Prognosis
Radiotherapy is one of the main treatment modalities for rectal cancer. Neoadjuvant chemoradiotherapy has been accepted as the standard treatment in rectal cancer. Evaluation the treatment results in patients who underwent neoadjuvant chemoradiotherapy were aimed in this study. Between 2009 and 2019, patients with local advanced rectal cancer who underwent neoadjuvant radiotherapy and subsequent surgery in our clinic were retrospectively analyzed. The clinical pathological features, treatment responses and prognostic factors affecting survival of 99 patients were investigated. Radiotherapy dose was 25 Gy in 5 fractions in 11 patients and 50.4 Gy in 28 fractions in 88 patients. Thirty-three of the patients were female and 66 were male and the median age was 60 (30-80). According to tumor locations, 30.3% are located in the upper, 26.3% in the middle, and 43.4% in the distal rectum. The distribution according to clinical radiological stages before radiotherapy were 2% T2, 72.7% T3, 25.3% T4 and 52.5% N0, 47.5% N1-2. Pathological complete response (pCR) was determined in 10.2% of the patients who received long-term chemoradiotherapy. Eight patients developed local recurrence and 12 patients developed distant metastases. Five-year disease-free and overall survival rates were 66% and 76%, respectively. Stage and location of the tumor were found to be effective factors in overall survival. No grade 3 acute or late gastrointestinal and genitourinary system toxicities were observed. Neoadjuvant chemoradiotherapy is an effective treatment for rectal cancer. Determination of clinical pathological prognostic factors in larger series will be effective in treatment selection.