Online

ESTRO 2020

Session Item

Clinical track: Lower GI (colon, rectum, anus)
9306
Poster
Clinical
23:00 - 23:00
Dose intensification in locally advanced rectal cancer: a prospective observational study
PO-1106

Abstract

Dose intensification in locally advanced rectal cancer: a prospective observational study
Authors: BERTOCCHI|, Elisa(1)*[nicosialu@gmail.com];Nicosia|, Luca(2);Mazzola|, Rosario(2);Barugola|, Giuliano(1);Ricchetti|, Francesco(2);Dell'Abate|, Paolo(1);Ruffo|, Giacomo(1);Alongi|, Filippo(2);
(1)IRCCS - Ospedale Sacro Cuore Don Calabria, Department of Surgery, Negrar, Italy;(2)IRCCS - Ospedale Sacro Cuore Don Calabria, Department of Advanced Radiation Oncology, Negrar, Italy;
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Purpose or Objective

The potential role of neoadjuvant radiation dose intensification in locally advanced rectal cancer (LARC) is still largely debated. In the present study, a comparative analysis between radiation dose intensification and conventional fractionation was performed.

Material and Methods

In the current prospective observational study, 56 patients diagnosed with LARC were enrolled between January 2013 and December 2016. More specifically, 25 patients underwent pre-operative conventional radiation dose (i.e. 50.4 Gy in 28 fractions here defined as SDR – group 1) whereas 31 patients were candidate to radiation dose intensification (i.e. 60 Gy in 30 fractions here defined as RDI - group 2). The primary end-point was the complete pathological response (pCR) rate. Secondary end-points were post-operative complications and ChT-RT related toxicity. 

Results

No statistical significance was observed in pCR rate (i.e. 20.8% in SDR group and 22.6% in RDI, p=0.342). Of contrast, the RDI group showed a significantly higher primary tumor downstaging in case of T3 tumors comparing to SDR group (p=0.049). All patients had R0 margins. No surgical related death was recorded. No statistically significanct difference was observed regarding surgical complications between SDR and RDI (28% versus 41.9%, respectively; p=0.40). Not surgical complications were higher in RDI group (p<0.05). Acute genito-urinary toxicity was significantly higher in RDI group (p=0.015).

Conclusion

The intensification of the neoadjuvant radiotherapy for LARC seems to produce a major pathological response in T3 tumors. The radiation dose intensification is not correlated with the rate of radiation toxicity, surgical complications and complexity.