eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
Current Issue Archive Supplements Articles in Press Journal Information Aims and Scope Editorial Office Editorial Board Register as Author Register as Reviewer Instructions for Authors Abstracting and indexing Subscription Advertising Information Links
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank

2/2023
vol. 15
 
Share:
Share:
abstract:
Original paper

Complication and response assessment of high-dose-rate endorectal brachytherapy boost in neo-adjuvant chemoradiotherapy of locally advanced rectal cancer with long-term outcomes

Arefeh Saeedian
1, 2
,
Marzieh Lashkari
1, 2
,
Reza Ghalehtaki
1, 2
,
Maryam Taherioun
1, 2
,
Mahdieh Razmkhah
1, 2
,
Ali Kazemian
1, 2
,
Mahdi Aghili
1, 2

1.
Radiation Oncology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
2.
Department of Radiation Oncology, Tehran University of Medical Sciences, Tehran, Iran
J Contemp Brachytherapy 2023; 15, 2: 117–122
Online publish date: 2023/04/28
View full text Get citation
 
Purpose:
To identify efficacy, complication, and pathologic response of high-dose-rate endorectal brachytherapy (HDR-BRT) boost in neo-adjuvant chemoradiotherapy (nCRT) of locally advanced rectal cancer.

Material and methods:
Forty-four patients who met eligibility criteria were included in this non-randomized comparative study. Control group was recruited retrospectively. nCRT (50.40 Gy/28 fr. plus capecitabine 825 mg/m2 twice daily) was administered to both groups before surgery. In the case group, HDR-BRT (8 Gy/2 fr.) was supplemented after chemoradiation. Surgery was done 6-8 weeks after completion of neo-adjuvant therapy. Pathologic complete response (pCR) was the study’s primary endpoint.

Results:
From 44 patients in the case and control groups, pCR was 11 (50%) and 8 (36.4%), respectively (p = 0.27). According to Ryan’s grading system, tumor regression grade (TRG) TRG1, TRG2, and TRG3 were 16 (72.7%), 2 (9.1%), and 4 (18.2%) in the case, and 10 (45.5%), 7 (31.8%), and 5 (22.7%) in the control group (p = 0.118). T down-staging was found in 19 (86.4%) and 13 (59.1%) patients in the case and control groups, respectively. No grade > 2 toxicity was identified in both the groups. Organ preservation was achieved in 42.8% and 15.3% in the case and control arm (p = 0.192). In the case group, 8-year overall survival (OS) and disease-free survival (DFS) were 89% (95% CI: 73-100%) and 78% (95% CI: 58-98%), respectively. Our study did not reach median OS and median DFS.

Conclusions:
Treatment schedule was well-tolerated, and neo-adjuvant HDR-BRT could achieve better T down-staging as a boost comparing with nCRT, without significant complication. However, the optimal dose and fractions in the context of HDR-BRT boost needs further studies.

keywords:

brachytherapy, neo-adjuvant chemoradiotherapy, boost, dose escalation, rectal cancer

 
Quick links
© 2024 Termedia Sp. z o.o.
Developed by Bentus.