Role of adjuvant chemotherapy in ypT0-2N0 patients treated with preoperative chemoradiation therapy and radical resection for rectal cancer
- Authors
- Park I.J.[Park I.J.]; Kim D.Y.[Kim D.Y.]; Kim H.C.[Kim H.C.]; Kim N.K.[Kim N.K.]; Kim H.-R.[Kim H.-R.]; Kang S.-B.[Kang S.-B.]; Choi G.-S.[Choi G.-S.]; Lee K.Y.[Lee K.Y.]; Kim S.-H.[Kim S.-H.]; Oh S.T.[Oh S.T.]; Lim S.-B.[Lim S.-B.]; Kim J.C.[Kim J.C.]; Oh J.H.[Oh J.H.]; Kim S.Y.[Kim S.Y.]; Lee W.Y.[Lee W.Y.]; Lee J.B.[Lee J.B.]; Yu C.S.[Yu C.S.]
- Issue Date
- 2015
- Citation
- International Journal of Radiation Oncology Biology Physics, v.92, no.3, pp.540 - 547
- Journal Title
- International Journal of Radiation Oncology Biology Physics
- Volume
- 92
- Number
- 3
- Start Page
- 540
- End Page
- 547
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/49470
- DOI
- 10.1016/j.ijrobp.2015.02.020
- Abstract
- Objective To explore the role of adjuvant chemotherapy for patients with ypT0-2N0 rectal cancer treated by preoperative chemoradiation therapy (PCRT) and radical resection. Patients and Methods A national consortium of 10 institutions was formed, and patients with ypT0-2N0 mid- and low-rectal cancer after PCRT and radical resection from 2004 to 2009 were included. Patients were categorized into 2 groups according to receipt of additional adjuvant chemotherapy: Adj CTx (+) versus Adj CTx (-). Propensity scores were calculated and used to perform matched and adjusted analyses comparing relapse-free survival (RFS) between treatment groups while controlling for potential confounding. Results A total of 1016 patients, who met the selection criteria, were evaluated. Of these, 106 (10.4%) did not receive adjuvant chemotherapy. There was no overall improvement in 5-year RFS as a result of adjuvant chemotherapy [91.6% for Adj CTx (+) vs 87.5% for Adj CTx (-), P=.18]. There were no differences in 5-year local recurrence and distant metastasis rate between the 2 groups. In patients who show moderate, minimal, or no regression in tumor regression grade, however, possible association of adjuvant chemotherapy with RFS would be considered (hazard ratio 0.35; 95% confidence interval 0.14-0.88; P=.03). Cox regression analysis after propensity score matching failed to show that addition of adjuvant chemotherapy was associated with improved RFS (hazard ratio 0.81; 95% confidence interval 0.39-1.70; P=.58). Conclusions Adjuvant chemotherapy seemed to not influence the RFS of patients with ypT0-2N0 rectal cancer after PCRT followed by radical resection. Thus, the addition of adjuvant chemotherapy needs to be weighed against its oncologic benefits. ? 2015 Elsevier Inc. All rights reserved.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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