The Role of Simultaneous Integrated Boost in Locally Advanced Rectal Cancer Patients with Positive Lateral Pelvic Lymph Nodes
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Imaging
2.3. Neoadjuvant Treatment
2.4. Surgery
Clinical Workflow
- oxaliplatin iv 50 mg/m2/day 1, 8, 21, 28, and 5-Fluorouracil 250 mg/m2/day days 1–7 during the 1st–2nd and 4th–5th week of radiotherapy
- oxaliplatin iv 60 mg/m2/day g1 q7 and capecitabine per os 1300 mg/m2/day 1–7 days
- 5-fluorouracil iv 225 mg/m2/day in continuous infusion days 1–7 q7
- capecitabine per os 1650 mg/m2/day 1–7 q7
- capecitabine per os 1650 mg/m2/day days 1–5 q7 and avelumab iv 10 mg/kg/dieg1 q14
2.5. Follow-Up
2.6. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Inclusion Criteria |
• Histologically documented adenocarcinoma of the rectum; • Minimum age of 18; • Locally advanced non-metastatic rectal cancer; • Undergoing neoadjuvant CRT treatment followed or not by TME surgery; • MRI pelvis staging and restaging available; • Follow-up of at least one year; • Signature of informed consent to the processing of their data, if applicable. |
Exclusion Criteria |
• Patients treated for palliative purposes; • Patients with metastatic disease. |
Patient’s Characteristics | Boost Yes | Boost No | p Value § |
---|---|---|---|
Sex | 0.368 | ||
Male | 46 (56.1%) | 59 (62.8%) | |
Female | 36 (43.9%) | 35 (37.2%) | |
Age | 0.760 | ||
≤50 years | 9 (11%) | 9 (9.6%) | |
<50 years | 73 (89%) | 85 (90.4%) | |
cT | 0.644 | ||
2 | 1 (1.2%) | 2 (2.1%) | |
3 | 49 (59.8%) | 50 (53.2%) | |
4 | 32 (39%) | 42 (44.7%) | |
cN | 0.577 | ||
1 | 19 (23.2%) | 21 (22.3%) | |
2 | 63 (76.8%) | 73 (77.7%) | |
EMVI | 0.001 | ||
+ | 9 (11%) | 5 (5.3%) | |
− | 71 (86.6%) | 69 (73.4%) | |
N/A | 2 (2.4%) | 20 (21.3%) | |
Mucinous | 0.003 | ||
Yes | 4 (4.9%) | 6 (6.4%) | |
No | 76 (92.7%) | 71 (75.5%) | |
N/A | 2 (2.4%) | 17 (18.1%) | |
MRF | 0.834 | ||
+ | 40 (48.8%) | 48 (51.1%) | |
− | 38 (46.3%) | 43 (45.7%) | |
N/A | 4 (4.9%) | 3 (3.2%) | |
Surgery Type | 0.101 | ||
Anterior Resection (AR) | 53 (64.6%) | 56 (59.6%) | |
Abdominoperineal Resection (APR) | 20 (24.4%) | 20 (21.3%) | |
Hartmann | 1 (1.2%) | 5 (5.3%) | |
Local Excision | 7 (8.5%) | 5 (5.3%) | |
Colostomy | 1 (1.2%) | 8 (8.5%) | |
RT dose on T | <0.001 | ||
55 Gy | 78 (95.1%) | 71 (75.5%) | |
<55 Gy | 4 (4.9%) | 23 (24.5%) | |
RT dose on LPLN | 8.45 | ||
55 Gy | 78 (95.1%) | 0 (0%) | |
<55 Gy | 4 (4.9%) | 94 (100%) |
Patient’s Characteristics | OS | DFS | MFS | LC | ||||
---|---|---|---|---|---|---|---|---|
Univariate | Multivariate | Univariate | Multivariate | Univariate | Multivariate | Univariate | Multivariate | |
p-Value | p-Value | p-Value | p-Value | p-Value | p-Value | p-Value | p-Value | |
Gender | 0.09 | 0.29 | 0.42 | 0.44 | ||||
Age | 0.50 | 0.25 | 0.24 | 0.27 | ||||
cT | 0.04 | 0.01 | 0.03 | 0.05 | 0.04 | 0.02 | 0.22 | 0.16 |
cN | 0.74 | 0.37 | 0.07 | 0.58 | ||||
EMVI | 0.46 | 0.98 | 0.99 | 0.99 | ||||
Mucinous | 0.63 | 0.98 | 0.99 | 0.99 | ||||
Mesorectal Fascia (MRF) | 0.63 | 0.61 | 0.37 | 0.15 | ||||
Surgery Type | 0.17 | 0.02 | 0.07 | 0.29 | <0.001 | 0.01 | ||
RT dose on T | 0.04 | 0.06 | 0.49 | 0.77 | 0.15 | |||
RT dose on LPLN | <0.01 | 0.03 | <0.01 | 0.01 | 0.04 | 0.04 | 0.04 | 0.08 |
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Meldolesi, E.; Chiloiro, G.; Giannini, R.; Menghi, R.; Persiani, R.; Corvari, B.; Coco, C.; Manfrida, S.; Ratto, C.; De Luca, V.; et al. The Role of Simultaneous Integrated Boost in Locally Advanced Rectal Cancer Patients with Positive Lateral Pelvic Lymph Nodes. Cancers 2022, 14, 1643. https://doi.org/10.3390/cancers14071643
Meldolesi E, Chiloiro G, Giannini R, Menghi R, Persiani R, Corvari B, Coco C, Manfrida S, Ratto C, De Luca V, et al. The Role of Simultaneous Integrated Boost in Locally Advanced Rectal Cancer Patients with Positive Lateral Pelvic Lymph Nodes. Cancers. 2022; 14(7):1643. https://doi.org/10.3390/cancers14071643
Chicago/Turabian StyleMeldolesi, Elisa, Giuditta Chiloiro, Roberta Giannini, Roberta Menghi, Roberto Persiani, Barbara Corvari, Claudio Coco, Stefania Manfrida, Carlo Ratto, Viola De Luca, and et al. 2022. "The Role of Simultaneous Integrated Boost in Locally Advanced Rectal Cancer Patients with Positive Lateral Pelvic Lymph Nodes" Cancers 14, no. 7: 1643. https://doi.org/10.3390/cancers14071643