THURSDAY, Sept. 12, 2024 (HealthDay News) — For patients with locally advanced rectal cancer pursuing organ preservation, long-course chemoradiotherapy (LCCRT) is the preferred total neoadjuvant therapy (TNT) regimen, according to a study published online Sept. 11 in the Annals of Oncology to coincide with the European Society for Medical Oncology Congress 2024, being held from Sept. 13 to 17 in Barcelona, Spain.
Aron Bercz, M.D., from Memorial Sloan Kettering Cancer Center in New York City, and colleagues examined potential differences in organ preservation in rectal cancer between TNT regimens integrating LCCRT and short-course radiotherapy (SCRT), the latter of which was introduced in response to the COVID-19 pandemic. The analyses included 323 locally advanced rectal adenocarcinoma patients treated with LCCRT (247 patients) and SCRT (76 patients) from January 2018 to January 2021. Organ preservation with watch-and-wait (WW) management was offered to patients who achieved clinical complete response.
Patients were followed for a median of 31 months. The researchers found similar clinical complete response rates after LCCRT and SCRT (44.5 versus 43.4 percent). Among patients treated with LCCRT and SCRT, two-year organ preservation was 40 and 31 percent, respectively. In patients managed with WW, compared with SCRT, LCCRT resulted in higher two-year organ preservation (89 versus 70 percent) and lower two-year local regrowth (19 versus 36 percent). WW patients treated with LCCRT and SCRT had similar two-year distant recurrence (10 versus 6 percent), disease-free survival (90 versus 90 percent), and overall survival (99 versus 100 percent).
“These findings provide timely insights for patients considering organ preservation strategies and support induction LCCRT followed by consolidation chemotherapy as the preferred TNT regimen,” the authors write.
Several authors disclosed ties to the pharmaceutical industry.
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