Details

Autor(en) / Beteiligte

• Picardi, Vincenzo, MD
• Deodato, Francesco, MD
• Guido, Alessandra, MD, PhD
• Giaccherini, Lucia, MD
• Macchia, Gabriella, MD
• Frazzoni, Leonardo, MD
• Farioli, Andrea, MD
• Cuicchi, Dajana, MD
• Cilla, Savino, MD
• Cellini, Francesco, MD
• Uddin, A.F.M. Kamal, MD
• Gambacorta, Maria Antonietta, MD
• Buwenge, Milly, PhD
• Ardizzoni, Andrea, MD
• Poggioli, Gilberto, MD
• Valentini, Vincenzo, MD
• Fuccio, Lorenzo, MD
• Morganti, Alessio G., MD

Titel

Palliative Short-Course Radiation Therapy in Rectal Cancer: A Phase 2 Study

Ist Teil von

• International journal of radiation oncology, biology, physics, 2016-07, Vol.95 (4), p.1184-1190

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2016

Quelle

MEDLINE

Beschreibungen/Notizen

• Purpose The management of patients with symptomatic rectal cancer not amenable to curative treatment may be challenging. The aim of this phase 2 study was to evaluate the efficacy of short-course radiation therapy in patients with obstructing rectal cancer. Methods and Materials Patients who were not candidates for surgical resection because of synchronous metastases, age, and/or comorbidities were considered eligible. The sample size was calculated based on the 2-stage design of Simon. Short-course radiation therapy was delivered with an isocentric 4-field box technique (total, 25 Gy; 5 fractions in 5 days). Chemotherapy was suspended during radiation treatment. Clinical outcome measures were symptomatic response rate, toxicity, colostomy-free survival, and overall survival. Results From October 2003 to November 2012, 18 patients (median age, 77.5 years) were enrolled. The median follow-up was 11.5 months (range, 3-36 months). Four weeks after treatment, a complete response (ie, complete symptom resolution) was observed in 38.9% of patients and a partial response in 50.0% cases, whereas 11.1% had no response. The rates of reduction or resolution of pain and bleeding were 87.5% and 100%, respectively. The 1-, 2-, and 3-year colostomy-free survival rates were 100%, 71.4%, and 47.6%, respectively (median, 30 months). The 1-, 2-, and 3-year cumulative overall survival rates were 85.2%, 53%, and 39.8%, respectively (median, 25 months). No patients stopped treatment because of gastrointestinal or genitourinary toxicities: 38.9% of patients had grade 1 to 2 toxicity, and 16.7% had grade 3 toxicity. Only 1 patient had hematologic grade 2 toxicity, and 2 patients had grade 2 skin toxicity. Conclusions Short-course radiation therapy may represent a safe and effective alternative treatment option in patients with obstructing rectal cancer not eligible for curative treatment, allowing colostomy to be avoided in a substantial proportion of patients.