The Impact on Survival of Neoadjuvant Treatment Interruptions in Locally Advanced Rectal Cancer Patients
The standard oncologic treatment of locally advanced rectal cancer is long-course radio-chemotherapy followed by surgery and adjuvant chemotherapy. This can result in a lengthy total treatment duration, sometimes up to one year from the diagnosis. Interruptions to neoadjuvant treatment can occur for...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-02-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/14/3/266 |
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| author | Horia-Dan Lișcu Ionut-Lucian Antone-Iordache Dimitrie-Ionuț Atasiei Ioana Valentina Anghel Andreea-Teodora Ilie Taraneh Emamgholivand Andreea-Iuliana Ionescu Florica Șandru Christopher Pavel Flavia Ultimescu |
| author_facet | Horia-Dan Lișcu Ionut-Lucian Antone-Iordache Dimitrie-Ionuț Atasiei Ioana Valentina Anghel Andreea-Teodora Ilie Taraneh Emamgholivand Andreea-Iuliana Ionescu Florica Șandru Christopher Pavel Flavia Ultimescu |
| author_sort | Horia-Dan Lișcu |
| collection | DOAJ |
| description | The standard oncologic treatment of locally advanced rectal cancer is long-course radio-chemotherapy followed by surgery and adjuvant chemotherapy. This can result in a lengthy total treatment duration, sometimes up to one year from the diagnosis. Interruptions to neoadjuvant treatment can occur for a variety of reasons, forced or unforced. The main purpose of this study is to analyze the survival data of locally advanced rectal cancer patients who received neoadjuvant treatment and to find a cut-off point showing exactly how many days of interruption of neoadjuvant treatment the risk of death or disease relapse increases. We conducted a retrospective study on 299 patients with locally advanced rectal cancer using survival analysis (Kaplan–Meier curve and Cox regression) to determine survival probabilities for overall survival, local control, and disease-free survival. Patients with 0 to 3 days of neoadjuvant therapy interruption had a higher overall survival probability compared to patients with 4 or more days (90.2% compared to 57.9%, <i>p</i>-value < 0.001), hazard ratio 5.89 (<i>p</i> < 0.001). Local control and disease-free survival had a higher probability in patients with 0–2 days of interruption compared to people with 3 or more days (94% vs. 75.4%, and 82.2% vs. 50.5%, respectively, both <i>p</i>-values < 0.001). Patients with tumoral or nodal downstaging experienced fewer days of interruption than patients with no downstage. These findings reinforce the need for radiation oncologists to be well-organized when starting neoadjuvant treatment for rectal cancer, in order to anticipate and prevent potential treatment interruptions and achieve the best therapeutic results. |
| first_indexed | 2024-04-24T18:06:18Z |
| format | Article |
| id | doaj.art-bfca750b900141839350b2e310560302 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-04-24T18:06:18Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-bfca750b900141839350b2e3105603022024-03-27T13:50:07ZengMDPI AGJournal of Personalized Medicine2075-44262024-02-0114326610.3390/jpm14030266The Impact on Survival of Neoadjuvant Treatment Interruptions in Locally Advanced Rectal Cancer PatientsHoria-Dan Lișcu0Ionut-Lucian Antone-Iordache1Dimitrie-Ionuț Atasiei2Ioana Valentina Anghel3Andreea-Teodora Ilie4Taraneh Emamgholivand5Andreea-Iuliana Ionescu6Florica Șandru7Christopher Pavel8Flavia Ultimescu9Discipline of Oncological Radiotherapy and Medical Imaging, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDiscipline of Oncological Radiotherapy and Medical Imaging, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDiscipline of Oncological Radiotherapy and Medical Imaging, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDiscipline of Oncological Radiotherapy and Medical Imaging, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDiscipline of Oncological Radiotherapy and Medical Imaging, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDiscipline of Oncological Radiotherapy and Medical Imaging, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDiscipline of Oncological Radiotherapy and Medical Imaging, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Dermatology, Elias University Emergency Hospital, 011461 Bucharest, RomaniaDepartment of Gastroenterology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Pathology, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, RomaniaThe standard oncologic treatment of locally advanced rectal cancer is long-course radio-chemotherapy followed by surgery and adjuvant chemotherapy. This can result in a lengthy total treatment duration, sometimes up to one year from the diagnosis. Interruptions to neoadjuvant treatment can occur for a variety of reasons, forced or unforced. The main purpose of this study is to analyze the survival data of locally advanced rectal cancer patients who received neoadjuvant treatment and to find a cut-off point showing exactly how many days of interruption of neoadjuvant treatment the risk of death or disease relapse increases. We conducted a retrospective study on 299 patients with locally advanced rectal cancer using survival analysis (Kaplan–Meier curve and Cox regression) to determine survival probabilities for overall survival, local control, and disease-free survival. Patients with 0 to 3 days of neoadjuvant therapy interruption had a higher overall survival probability compared to patients with 4 or more days (90.2% compared to 57.9%, <i>p</i>-value < 0.001), hazard ratio 5.89 (<i>p</i> < 0.001). Local control and disease-free survival had a higher probability in patients with 0–2 days of interruption compared to people with 3 or more days (94% vs. 75.4%, and 82.2% vs. 50.5%, respectively, both <i>p</i>-values < 0.001). Patients with tumoral or nodal downstaging experienced fewer days of interruption than patients with no downstage. These findings reinforce the need for radiation oncologists to be well-organized when starting neoadjuvant treatment for rectal cancer, in order to anticipate and prevent potential treatment interruptions and achieve the best therapeutic results.https://www.mdpi.com/2075-4426/14/3/266neoadjuvant radiotherapytotal neoadjuvant treatmentlocally advanced rectal cancerdownstagetreatment interruptions |
| spellingShingle | Horia-Dan Lișcu Ionut-Lucian Antone-Iordache Dimitrie-Ionuț Atasiei Ioana Valentina Anghel Andreea-Teodora Ilie Taraneh Emamgholivand Andreea-Iuliana Ionescu Florica Șandru Christopher Pavel Flavia Ultimescu The Impact on Survival of Neoadjuvant Treatment Interruptions in Locally Advanced Rectal Cancer Patients Journal of Personalized Medicine neoadjuvant radiotherapy total neoadjuvant treatment locally advanced rectal cancer downstage treatment interruptions |
| title | The Impact on Survival of Neoadjuvant Treatment Interruptions in Locally Advanced Rectal Cancer Patients |
| title_full | The Impact on Survival of Neoadjuvant Treatment Interruptions in Locally Advanced Rectal Cancer Patients |
| title_fullStr | The Impact on Survival of Neoadjuvant Treatment Interruptions in Locally Advanced Rectal Cancer Patients |
| title_full_unstemmed | The Impact on Survival of Neoadjuvant Treatment Interruptions in Locally Advanced Rectal Cancer Patients |
| title_short | The Impact on Survival of Neoadjuvant Treatment Interruptions in Locally Advanced Rectal Cancer Patients |
| title_sort | impact on survival of neoadjuvant treatment interruptions in locally advanced rectal cancer patients |
| topic | neoadjuvant radiotherapy total neoadjuvant treatment locally advanced rectal cancer downstage treatment interruptions |
| url | https://www.mdpi.com/2075-4426/14/3/266 |
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