Current status of neoadjuvant therapy for locally advanced rectal cancer in Wuhan Union Hospital Cancer Center
Abstract Background To analyze and explore the evolution and short-term efficacy of neoadjuvant therapy for patients with mid and low LARC in Wuhan Union Hospital Cancer Center. Methods Patients diagnosed with rectal cancer from January 2015 to December 2021 were collected. The treatment patterns, s...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13014-022-02081-8 |
| _version_ | 1818257028042194944 |
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| author | Meng-Lan Zhai Fang-Yuan Zhang Jin-Ru Yang Sheng Zhang Lei Zhao Zhen-Yu Lin Jing Wang Dan-Dan Yu Tao Zhang |
| author_facet | Meng-Lan Zhai Fang-Yuan Zhang Jin-Ru Yang Sheng Zhang Lei Zhao Zhen-Yu Lin Jing Wang Dan-Dan Yu Tao Zhang |
| author_sort | Meng-Lan Zhai |
| collection | DOAJ |
| description | Abstract Background To analyze and explore the evolution and short-term efficacy of neoadjuvant therapy for patients with mid and low LARC in Wuhan Union Hospital Cancer Center. Methods Patients diagnosed with rectal cancer from January 2015 to December 2021 were collected. The treatment patterns, short-term efficacy and treatment-related adverse events (AEs) of mid and low LARC patients who received neoadjuvant therapy were analyzed. The Chi-square test was used to compare the differences between groups. Results A total of 980 patients with mid and low LARC were enrolled, over time, the proportion of patients receiving neoadjuvant therapy gradually increased, and the treatment mode of direct surgery after diagnosis was gradually watered down. More than 80% of the patients implemented radiotherapy-based neoadjuvant therapy, and the proportion of patients receiving SCRT sequential systemic therapy gradually exceeded that of LCRT combined chemotherapy after 2020. Of all patients who completed radiotherapy and underwent surgery, 170 patients received long-course chemoradiotherapy (LCRT) combined with chemotherapy (Group C) and 98 patients received short-course radiotherapy (SCRT) combined with systemic therapy (chemotherapy with or without immunotherapy) (Group D). The pathological complete response (pCR) rate in Group D was significantly higher than that in Group C (38.8% vs. 19.4%, P = 0.001). The pCR rate in the SCRT plus immunotherapy group was better than that in the group without immunotherapy (49.2% vs. 21.6%, P = 0.007). 82.3% of the patients receiving immunotherapy were treated with SCRT sequential 2-cycle CapOX plus Camrelizumab treatment, and the pCR was as high as 52.9%. Immunotherapy did not increase the incidence of Grade 3–4 AEs. Conclusions Neoadjuvant therapy based on radiotherapy is becoming used in patients with mid and low LARC. SCRT sequential systemic therapy is increasingly widely used in LARC patients in our center. Compared with the traditional LCRT or SCRT sequential chemotherapy, SCRT sequential chemotherapy plus immunotherapy has a remarkable pCR rate and manageable toxicity. Looking forward this new treatment mode will bring lasting survival benefits to patients. |
| first_indexed | 2024-12-12T17:37:08Z |
| format | Article |
| id | doaj.art-28e526fbf6e649eda172305431056c56 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-12T17:37:08Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-28e526fbf6e649eda172305431056c562022-12-22T00:17:11ZengBMCRadiation Oncology1748-717X2022-06-011711910.1186/s13014-022-02081-8Current status of neoadjuvant therapy for locally advanced rectal cancer in Wuhan Union Hospital Cancer CenterMeng-Lan Zhai0Fang-Yuan Zhang1Jin-Ru Yang2Sheng Zhang3Lei Zhao4Zhen-Yu Lin5Jing Wang6Dan-Dan Yu7Tao Zhang8Cancer Center, Tongji Medical College, Union Hospital, Huazhong University of Science and TechnologyCancer Center, Tongji Medical College, Union Hospital, Huazhong University of Science and TechnologyCancer Center, Tongji Medical College, Union Hospital, Huazhong University of Science and TechnologyCancer Center, Tongji Medical College, Union Hospital, Huazhong University of Science and TechnologyCancer Center, Tongji Medical College, Union Hospital, Huazhong University of Science and TechnologyCancer Center, Tongji Medical College, Union Hospital, Huazhong University of Science and TechnologyCancer Center, Tongji Medical College, Union Hospital, Huazhong University of Science and TechnologyCancer Center, Tongji Medical College, Union Hospital, Huazhong University of Science and TechnologyCancer Center, Tongji Medical College, Union Hospital, Huazhong University of Science and TechnologyAbstract Background To analyze and explore the evolution and short-term efficacy of neoadjuvant therapy for patients with mid and low LARC in Wuhan Union Hospital Cancer Center. Methods Patients diagnosed with rectal cancer from January 2015 to December 2021 were collected. The treatment patterns, short-term efficacy and treatment-related adverse events (AEs) of mid and low LARC patients who received neoadjuvant therapy were analyzed. The Chi-square test was used to compare the differences between groups. Results A total of 980 patients with mid and low LARC were enrolled, over time, the proportion of patients receiving neoadjuvant therapy gradually increased, and the treatment mode of direct surgery after diagnosis was gradually watered down. More than 80% of the patients implemented radiotherapy-based neoadjuvant therapy, and the proportion of patients receiving SCRT sequential systemic therapy gradually exceeded that of LCRT combined chemotherapy after 2020. Of all patients who completed radiotherapy and underwent surgery, 170 patients received long-course chemoradiotherapy (LCRT) combined with chemotherapy (Group C) and 98 patients received short-course radiotherapy (SCRT) combined with systemic therapy (chemotherapy with or without immunotherapy) (Group D). The pathological complete response (pCR) rate in Group D was significantly higher than that in Group C (38.8% vs. 19.4%, P = 0.001). The pCR rate in the SCRT plus immunotherapy group was better than that in the group without immunotherapy (49.2% vs. 21.6%, P = 0.007). 82.3% of the patients receiving immunotherapy were treated with SCRT sequential 2-cycle CapOX plus Camrelizumab treatment, and the pCR was as high as 52.9%. Immunotherapy did not increase the incidence of Grade 3–4 AEs. Conclusions Neoadjuvant therapy based on radiotherapy is becoming used in patients with mid and low LARC. SCRT sequential systemic therapy is increasingly widely used in LARC patients in our center. Compared with the traditional LCRT or SCRT sequential chemotherapy, SCRT sequential chemotherapy plus immunotherapy has a remarkable pCR rate and manageable toxicity. Looking forward this new treatment mode will bring lasting survival benefits to patients.https://doi.org/10.1186/s13014-022-02081-8Rectal cancerNeoadjuvant therapyLong course chemoradiotherapyShort-course radiotherapyPathological complete response |
| spellingShingle | Meng-Lan Zhai Fang-Yuan Zhang Jin-Ru Yang Sheng Zhang Lei Zhao Zhen-Yu Lin Jing Wang Dan-Dan Yu Tao Zhang Current status of neoadjuvant therapy for locally advanced rectal cancer in Wuhan Union Hospital Cancer Center Radiation Oncology Rectal cancer Neoadjuvant therapy Long course chemoradiotherapy Short-course radiotherapy Pathological complete response |
| title | Current status of neoadjuvant therapy for locally advanced rectal cancer in Wuhan Union Hospital Cancer Center |
| title_full | Current status of neoadjuvant therapy for locally advanced rectal cancer in Wuhan Union Hospital Cancer Center |
| title_fullStr | Current status of neoadjuvant therapy for locally advanced rectal cancer in Wuhan Union Hospital Cancer Center |
| title_full_unstemmed | Current status of neoadjuvant therapy for locally advanced rectal cancer in Wuhan Union Hospital Cancer Center |
| title_short | Current status of neoadjuvant therapy for locally advanced rectal cancer in Wuhan Union Hospital Cancer Center |
| title_sort | current status of neoadjuvant therapy for locally advanced rectal cancer in wuhan union hospital cancer center |
| topic | Rectal cancer Neoadjuvant therapy Long course chemoradiotherapy Short-course radiotherapy Pathological complete response |
| url | https://doi.org/10.1186/s13014-022-02081-8 |
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