JOURNAL DESCRIPTION
The Medical Radiology and Radiation Safety journal ISSN 1024-6177 was founded in January 1956 (before December 30, 1993 it was entitled Medical Radiology, ISSN 0025-8334). In 2018, the journal received Online ISSN: 2618-9615 and was registered as an electronic online publication in Roskomnadzor on March 29, 2018. It publishes original research articles which cover questions of radiobiology, radiation medicine, radiation safety, radiation therapy, nuclear medicine and scientific reviews. In general the journal has more than 30 headings and it is of interest for specialists working in thefields of medicine¸ radiation biology, epidemiology, medical physics and technology. Since July 01, 2008 the journal has been published by State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. The founder from 1956 to the present time is the Ministry of Health of the Russian Federation, and from 2008 to the present time is the Federal Medical Biological Agency.
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Medical Radiology and Radiation Safety. 2020. Vol. 65. No. 2. P. 34–43
A.S. Abdujapparov, S.I. Tkachev, V.A. Aliev, D.S. Romanov, A.V. Nazarenko, Yu.A. Barsukov, T.N. Borisova, V.V. Glebovskaya
Immediate Results of a Prolonged Course of Neoadjuvant Chemoradiotherapy for Patients with Locally Advanced Rectal Cancer: a Comparison of Classical and Hypofractional Regimes
N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia
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Abstract
Purpose: To compare the effectiveness of the hypofractional and classical modes of radiation therapy in a neoadjuvant prolonged course of chemoradiotherapy for patients with locally advanced rectal cancer (LARC).
Material and methods: This work is based on a retrospective analysis of the database of patients with LARC, who from 2013 to 2017 underwent a prolonged course of neoadjuvant chemoradiotherapy with subsequent surgical intervention. Patients were divided into two groups: the first (main) group, 71 patients with LARC, who, as part of the neoadjuvant treatment, underwent a course of chemoradiotherapy (CRT) in the hypofractionation mode (4 Gy, 3 fractions per week, 32 Gy to regional lymph nodes pelvis and up to 40 Gy to the primary tumor) in combination with chemotherapy with capecitabine 1650 mg/m2 in two doses daily on weekdays. The second group (control group) included 79 patients with LARC, who underwent CRT in the classical fractionation regimen (2 Gy, 5 fractions per week, 44 Gy to regional pelvic lymph nodes and up to 50–58 Gy to the primary tumor) in combination with capecitabine chemotherapy 1650 mg/m2 in two doses on the days of radiation therapy.
Results: The average duration of a prolonged course of CRT in the main group was 22.56 (95 % CI from 21.94 to 23.18) calendar days, in the control group — 38.84 (95 % CI from 38.12 to 39.54), p = 0.0001. Pathological response of the III degree in the main group was recorded in 23 % of cases, and of the IV degree in 18 %, in the control group these indicators were 19 % and 15 %, respectively, p = 0.4. A decrease in the stage of the tumor process was recorded in 50 (70.4 %) cases in the main group and in 47 (59.5 %) cases in the control group, p = 0.16. No statistically significant differences were observed in the incidence and severity of cases of hematological and local toxicity.
Conclusion: The results of our study confirm that the use of a prolonged course of neoadjuvant chemoradiotherapy in hypofractionation mode does not worsen oncological results, does not increase the frequency and severity of early and late radiation injuries, but at the same time reduces the duration of the course of treatment by two weeks. The hypofractionation regimen can be considered as an alternative and not inferior to the classical regimen in the neoadjuvant course of CRT of patients with LARC.
Key words: neoadjuvant chemoradiotherapy, locally advanced rectal cancer, hypofractional regimen, prolonged course
For citation: Abdujapparov AS, Tkachev SI, Aliev VA, Romanov DS, Nazarenko AV, Barsukov YuA, Borisova TN, Glebovskaya VV. Immediate Results of a Prolonged Course of Neoadjuvant Chemoradiotherapy for Patients with Locally Advanced Rectal Cancer: a Comparison of Classical and Hypofractional Regimes. Medical Radiology and Radiation Safety. 2020;65(2):34-43. (In Russ.).
DOI: 10.12737/1024-6177-2020-65-2-34-43
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PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 28.11.2019.
Accepted for publication: 12.03.2020.