Neoadjuvant volumetric modulated arc radiochemotherapy with a simultaneous integrated boost technique compared to standard chemoradiation for locally advanced rectal cancer*

Natalia JANKARASHVILI; Sophio KAKHADZE; Maia TOPESHASHVILI; Lasha TURKIASHVILI; Mariam TCHIABRISHVILI

Makale detayları

Neoadjuvant volumetric modulated arc radiochemotherapy with a simultaneous integrated boost technique compared to standard chemoradiation for locally advanced rectal cancer*

Yazarlar:

Natalia JANKARASHVILI | Sophio KAKHADZE | Maia TOPESHASHVILI | Lasha TURKIASHVILI | Mariam TCHIABRISHVILI

Yayıncı:

TUBITAK

Dergi:

Turkish Journal of Medical Sciences 2019 Vol.49 Issue 5, pp.1484-1489

Belge Tipi:

Makale

Yayın Tarihi:

9/2019

Belge Dili:

İngilizce

Document ID (Org No.):

2000749898

Sıklık:

İki Aylık

eISSN:

1303-6165

pISSN:

1300-0144

Özet:

 

Background/aim: The present study aimed to examine whether the combination of neoadjuvant volumetric modulated arc radiotherapy (VMAT) using simultaneous integrated boost (SIB-VMAT) techniques and chemotherapy with capecitabine is associated with better clinical and dosimetric outcomes compared to the standard treatment.Materials  and  methods:  The  study  included  59  patients  with  cT2?T4  rectal  cancer.  In  the  standard  arm,  patients  (n  =  37)  were  treated  preoperatively with image-guided VMAT plus capecitabine. In the SIB arm, patients (n = 22) were treated with the SIB-VMAT technique plus capecitabine. All patients underwent radical surgical resection after neoadjuvant radiochemotherapy. Results: In the standard arm, cT0N0 was reached in 12 patients (32.4%), primary tumor clinical downstaging was observed in 22 patients (59.5%), and disease stability was achieved in 3 patients (8.1%). In the SIB arm, cT0N0 was reached in 15 patients (68.2%), primary tumor clinical  downstaging  was  observed  in  6  patients  (27.3%),  and  disease  stability  was  achieved  in  1  patient  (4.5%)  (P  =  0.028).  Complete  pathological response was observed in 11 patients (29.7%) in the standard arm and in 13 patients (59.1%) in the SIB arm (P = 0.026). In the SIB arm mild diarrhea appeared in 59.1%, moderate in 40.9%, and severe in 0% of the cases. In the standard arm mild, moderate, and severe diarrhea rates were in 54.1%, 43.2%, and 2.7%, respectively. In the SIB arm mild, moderate, and severe cystitis appeared in 63.6%, 22.7%, and 13.6%, while in the standard group mild cystitis developed in 67.6%, moderate in 24.3%, and severe in 8.1%. Mild, moderate, and severe radiation dermatitis rates were 45.5%, 45.5%, and 9.1% in the SIB group and 40.5%, 48.6%, and 10.8% in the standard group, respectively.Conclusion: The SIB-VMAT technique is effective and safe for irradiating locally advanced rectal cancer. Its effectiveness is expressed in higher clinical and pathological complete response rates and safety with the same rates of acute toxicity.

Makale detayları

Neoadjuvant volumetric modulated arc radiochemotherapy with a simultaneous integrated boost technique compared to standard chemoradiation for locally advanced rectal cancer*

Yazarlar: Natalia JANKARASHVILI | Sophio KAKHADZE | Maia TOPESHASHVILI | Lasha TURKIASHVILI | Mariam TCHIABRISHVILI

Yayıncı: TUBITAK

Dergi: Turkish Journal of Medical Sciences 2019 Vol.49 Issue 5, pp.1484-1489

Belge Tipi: Makale

Yayın Tarihi: 9/2019

Belge Dili: İngilizce

Document ID (Org No.): 2000749898

Sıklık: İki Aylık

eISSN: 1303-6165

pISSN: 1300-0144

Sayı

Yazarlar:

Natalia JANKARASHVILI | Sophio KAKHADZE | Maia TOPESHASHVILI | Lasha TURKIASHVILI | Mariam TCHIABRISHVILI

Yayıncı:

TUBITAK

Dergi:

Turkish Journal of Medical Sciences 2019 Vol.49 Issue 5, pp.1484-1489

Belge Tipi:

Makale

Yayın Tarihi:

9/2019

Belge Dili:

İngilizce

Document ID (Org No.):

2000749898

Sıklık:

İki Aylık

eISSN:

1303-6165

pISSN:

1300-0144