Shorter radiation courses followed by consolidation chemotherapy before surgery may be an effective treatment option for rectal cancer patients.
High volume bouts of chemoradiation are often used before surgery in rectal cancer patients to reduce tumor size and decrease the chances that cancer will recur. However, these regimens can often last longer than 5 weeks, causing severe side effects and reducing patients’ quality of life.
In an abstract to be presented at the 2016 Gastrointestinal Cancers Symposium (January 21-23; San Francisco, CA), Polish investigators report on data obtained from a phase 3 study testing the effectiveness of shorter course (5 days) radiation combined with consolidation chemotherapy before surgery.
The study enrolled 515 patients with locally advanced rectal cancer and assigned them to receive either chemoradiation or the experimental, shorter course regimen. Patients in both groups where administered different drug combinations and underwent surgery approximately 12 weeks after starting radiation therapy.
Results from the trial showed that there was no statistically significant difference in disease-free progression between the two groups (53% with the shorter course regimen vs 52% with standard chemoradiation). Overall survival was improved with the shorter course regimen as well (73% vs 63.5%). Further, due to the lower levels of radiation exposure, the patients treated with the shorter course regimen experienced a lower rate of acute toxicity (74% vs 83%), with the worst side-effects being inflammation of the rectum, diarrhea, inflammation of the bladder, and local skin radiation response.
The findings indicate no significant difference in efficacy between shorter radiation with consolidation chemotherapy and standard preoperative chemoradiation. In addition, the improved survival, lower toxicity, and lower cost favor the use of the shorter regimen. The researchers caution, however, that a longer follow-up evaluation will be necessary to confirm their results.
