Definitive high-dose radiotherapy with concurrent chemotherapy for locally advanced rectal cancer: A case report and literature review
- Abstract
- Background: Standard management for locally advanced rectal cancer (LARC) involves preoperative chemoradiotherapy (CRT)
and radical surgery. However, this level of treatment may be unnecessary for a subgroup of LARC patients. Previous reports have
shown that approximately 20% of LARC patients experience a complete tumor response to preoperative CRT. Post-CRT
nonoperative management of these patients may prevent morbidities associated with radical surgery. To our knowledge, this case
report firstly presents the favorable long-term outcomes of a LARC patient who underwent definitive aim CRT.
Methods: The patient was 73 years’ old, and staging workups revealed T3N2bM0 rectal adenocarcinoma. He agreed to receive
CRT, but refused surgery. A radiotherapy (RT) dose of 64.8 Gy was prescribed, which was higher than conventional (50.4 Gy)
preoperative aim RT. The regimen of concurrent chemotherapy was the same as that used in preoperative aim CRT: 2 cycles of
5-fluorouracil and leucovorin.
Results: Three months after CRT completion, a complete tumor response was identified clinically. Colonoscopic biopsy after 1 year
showed no tumor cells. This patient is alive after 4 years with no evidence of recurrence or severe toxicity.
Conclusion: The long-term outcomes of this case indicate the feasibility of definitive high-dose RT with concurrent chemotherapy
for LARC.
- All Author(s)
- M. J. Kim
; E. S. Kim
; S. G. Yeo
- Intsitutional Author(s)
- 김은석
- Issued Date
- 2016
- Type
- Article
- Keyword
- nonoperative management; radiation therapy; rectal cancer; watch-and-wait
- Publisher
- Lippincott Williams & Wilkins
- ISSN
- 0025-7974
; 1536-5964
- Citation Title
- Medicine
- Citation Volume
- 95
- Citation Number
- 40
- Citation Start Page
- e5059
- Citation End Page
- e5059
- Language(ISO)
- eng
- DOI
- 10.1097/md.0000000000005059
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/2420
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