PMID- 36185248
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221004
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 12
DP  - 2022
TI  - Prolonged neoadjuvant chemotherapy without radiation versus total neoadjuvant 
      therapy for locally advanced rectal cancer: A propensity score matched study.
PG  - 953790
LID - 10.3389/fonc.2022.953790 [doi]
LID - 953790
AB  - BACKGROUND: Although neoadjvuant chemoradiotherapy (CRT) improves the local 
      control rate of locally advanced rectal cancer (LARC), it fails to significantly 
      improve disease-free survival (DFS) and overall survival (OS). We explored the 
      efficacy of prolonged neoadjuvant chemotherapy (pNCT) without radiation and 
      compared this schema with total neoadjuvant therapy (TNT). MATERIAL AND METHODS: 
      Patients diagnosed with LARC and received TNT (4 cycles of induction 
      CapeOX/FOLFOX followed with CRT) or pNCT (6~8 cycles of CapeOX/FOLFOX) between 
      June 2016 and October 2021 were retrospective analyzed. All patients underwent 
      total mesorectal excision (TME). A 1:1 propensity score match was performed to 
      adjust baseline potential confounders. The tumor response, toxicity, 
      recurrence-free survival (RFS) and OS were observed. RESULTS: A total of 184 
      patients with 92 patients in each group were finally enrolled. The median 
      follow-up time was 35 months. TNT showed better pathological complete response 
      (pCR) rate (25.0% vs 16.3%) and objective regression rate (73.9% vs 59.8%) than 
      pNCT. TNT and pNCT produce similar 3-year RFS and OS rates in patients with 
      mid-to-upper rectal cancer. TNT was associated with improved tumor responsiveness 
      in all patients and improved 3-year RFS rates in those with low rectal cancer. 
      CONCLUSION: pNCT is an option for patients with mid-to-upper rectal cancer, but 
      radiation is still necessary for low rectal cancer. To determine optimal schema 
      for neoadjuvant therapy and patient selection, additional randomized controlled 
      studies are needed.
CI  - Copyright (c) 2022 Zhao, Han, Zhang, Ma, Dong, Zang, He and Zheng.
FAU - Zhao, Xuan
AU  - Zhao X
AD  - Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University 
      School of Medicine, Shanghai, China.
AD  - Shanghai Minimally Invasive Surgery Center, Shanghai, China.
FAU - Han, Peiyi
AU  - Han P
AD  - Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University 
      School of Medicine, Shanghai, China.
AD  - Shanghai Minimally Invasive Surgery Center, Shanghai, China.
FAU - Zhang, Luyang
AU  - Zhang L
AD  - Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University 
      School of Medicine, Shanghai, China.
AD  - Shanghai Minimally Invasive Surgery Center, Shanghai, China.
FAU - Ma, Junjun
AU  - Ma J
AD  - Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University 
      School of Medicine, Shanghai, China.
AD  - Shanghai Minimally Invasive Surgery Center, Shanghai, China.
FAU - Dong, Feng
AU  - Dong F
AD  - Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University 
      School of Medicine, Shanghai, China.
AD  - Shanghai Minimally Invasive Surgery Center, Shanghai, China.
FAU - Zang, Lu
AU  - Zang L
AD  - Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University 
      School of Medicine, Shanghai, China.
AD  - Shanghai Minimally Invasive Surgery Center, Shanghai, China.
FAU - He, Zirui
AU  - He Z
AD  - Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University 
      School of Medicine, Shanghai, China.
AD  - Shanghai Minimally Invasive Surgery Center, Shanghai, China.
FAU - Zheng, Minhua
AU  - Zheng M
AD  - Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University 
      School of Medicine, Shanghai, China.
AD  - Shanghai Minimally Invasive Surgery Center, Shanghai, China.
LA  - eng
PT  - Journal Article
DEP - 20220916
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC9523158
OTO - NOTNLM
OT  - chemoradiotherapy
OT  - neoadjuvant chemotherapy
OT  - propensity score
OT  - rectal cancer
OT  - recurrence
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/10/04 06:00
MHDA- 2022/10/04 06:01
PMCR- 2022/01/01
CRDT- 2022/10/03 04:16
PHST- 2022/05/26 00:00 [received]
PHST- 2022/08/25 00:00 [accepted]
PHST- 2022/10/03 04:16 [entrez]
PHST- 2022/10/04 06:00 [pubmed]
PHST- 2022/10/04 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2022.953790 [doi]
PST - epublish
SO  - Front Oncol. 2022 Sep 16;12:953790. doi: 10.3389/fonc.2022.953790. eCollection 
      2022.