Neoadjuvant chemoradiotherapy plus adjuvant chemotherapy versus adjuvant chemoradiotherapy in the treatment of patients with resectable rectal adenocarcinoma: a single-center 6-year study
The last 20 years have seen significant advances in the use of radiation and chemotherapy in the treatment of rectal cancer patients. Studies comparing preoperative chemoradiotherapy to postoperative chemoradiotherapy in Greek patients with resectable rectal adenocarcinoma are rare. Patients and Methods: We conducted a retrospective cohort study of 74 patients (48 men, 26 women, mean age 63,8 years) with resectable rectal stage II or III cancer. Eighteen patients received preoperative chemoradiotherapy and postoperative chemotherapy (group A). Fifty-six patients received postoperative chemoradiotherapy (group B). Chemotherapy consisted of Capecitabine alone or in combination with Oxaliplatin and 5-FU. Radiotherapy consisted of 25Gy (in 5 fractions in group A) or 45Gy (in 28 fractions in group B). Results: Overall 5-year survival was 69,7% (95% CI 50,3 - 89,1%). Median overall survival (OS) was 24,5 months. There was no statistically significant difference in survival curves and recurrence free survival (RFS) between the two treatment groups. Twelve patients (16,2%, 95% CI: 9,0 – 27,0%) developed recurrence. Total RFS was 22,5 months, 20,0 months in group A and 25,0 months in group B (N.S). Adverse effects of therapies were the same in both groups. Conclusions: Preoperative chemoradiotherapy did not enhance OS and RFS in stage II and III rectal carcinoma patients who received adjuvant chemotherapy.