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DOI: 10.1055/s-0045-1811218
COMPLETE CLINICAL RESPONSE AFTER TOTAL NEOADJUVANT THERAPY IN LOCALLY ADVANCED RECTAL CANCER: REAL WORLD DATA FROM A RETROSPECTIVE COHORT STUDY
Authors
Introduction: After ASCO 2020, Total Neoadjuvant Therapy (TNT) has become a widely adopted option in the treatment of locally advanced rectal cancer (LARC). Objective: To evaluate the overall complete clinical response (cCR) after TNT regimens in a population with LARC treated in the community. Method: Between May 2020 and Aug 2022 we performed a retrospective cohort study, including data from medical records of all consecutive patients with LARC treated with TNT in two health institutions in Salvador, Bahia, Brazil. Primary endpoint was the overall cCR after TNT. All patients were staging with digital rectal examination, rectal MRI and endoscopy after TNT. Results: A total of N=17 patients were included. Median age was 62 years (range: 46-74) and N=11 (65%) were male. According to 8th AJCC, N=12 (70%) were stage III and N=5 (30%) stage II. In addition, N=14 (82%) were cT3, N=2 (12%) were cT4, N=12 (70%) were cN1-2 and N=5 (30%) were cN0. Median distance of tumor from anal verge (AV) was 6cm (range: 0.8-12.2). N=7 (41%) were <5cm from AV and N=9 (53%) were between 5-10cm. A total of N=14 (82%) patients were submitted to the OPRA protocol (consolidation chemotherapy arm) and N=3 (18%) to the RAPIDO protocol. A total of N=9 patients has completed TNT and were included in the analysis of the primary outcome. Median follow-up from start of neoadjuvant treatment was 17.3 months (range: 7.822.2). Among these, N=3 (33%) showed a cCR and N=6 (66%) incomplete clinical response. Median time from completion of chemoradiation (OPRA) or radiation (RAPIDO) to restaging was 5.4 months (range: 4.5-8.3). All N=3 patients with cCR had been treated according to the OPRA protocol. Among these, one patient was treated with rectosigmoidectomy which showed a complete pathological response, the other two decided to undergo organ preservation protocol and have no evidence of tumor regrowth for at least 12 months. Conclusion: Preliminary data suggest that TNT regimens are feasible and active in patients with LARC treated in the real world. It can also be useful when adopting an organ preservation strategy.
No conflict of interest has been declared by the author(s).
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Publication History
Article published online:
03 November 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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Bruno Mendonça Protásio, Gabriela Alban, Pedro Rios, Mirela Souto, Matheus Villa, Marcony Andrade, Thiago Francischetto, Marcus Vinícius Lopes, Meyline Andrade, Carlos Ramon S. Mendes, Clarissa Mathias, Eduardo D. Moraes. COMPLETE CLINICAL RESPONSE AFTER TOTAL NEOADJUVANT THERAPY IN LOCALLY ADVANCED RECTAL CANCER: REAL WORLD DATA FROM A RETROSPECTIVE COHORT STUDY. Brazilian Journal of Oncology 2022; 18.
DOI: 10.1055/s-0045-1811218