Abstract:
Objective To investigate the short-term efficacy and toxicity of short-course radiotherapy with adjuvant chemotherapy and delayed surgery in patients with high-risk locally advanced rectal adenocarcinoma (LARC).
Methods We performed a retrospective analysis of 22 high-risk LARC patients who received preoperative short-course radiotherapy with adjuvant chemotherapy and delayed surgery in The Second Affiliated Hospital of Army Medical University between September 2015 and March 2021. All patients received short-course radiotherapy in combination with mFOLFOX6 regime or concurrent capetabine chemotherapy with a time interval of approximately 12 weeks between radiotherapy and surgery. The pathologic complete response (pCR) rate, downstaging rate, treatment-related toxicity, and surgical outcomes after treatment were analyzed.
Results All 22 patients completed short-course radiotherapy and adjuvant chemotherapy with a pCR and downstaging rate of 13.6% and 50%, respectively. Grade 3–4 acute toxicity occurred in 36.4% of patients. No treatment-related deaths were reported, and the 2-year overall survival and disease-free survival rates were 75.9% and 59.7%, respectively.
Conclusions Short-course radiotherapy combined with adjuvant chemotherapy and delayed surgery is a feasible treatment option for high-risk LARC. Acute toxicity can be tolerated, and the rate of down staging can be successfully increased.