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Simultaneous Integrated Boost Intensity-Modulated Radiation Therapy Can Benefit the Locally Advanced Rectal Cancer Patients With Clinically Positive Lateral Pelvic Lymph Node

BACKGROUND AND PURPOSE: The optimal treatment modality for clinically positive lateral pelvic lymph node (LPLN) from locally advanced rectal cancer (LARC) is unknown. Thus, we aimed to analyze the optimal radiotherapy dose for clinically positive LPLN from LARC. MATERIALS AND METHODS: We retrospecti...

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Autores principales: Li, Shuai, Zhang, Yangzi, Yu, Yang, Zhu, Xianggao, Geng, Jianhao, Teng, Huajing, Wang, Zhilong, Sun, Tingting, Wang, Lin, Wang, Hongzhi, Li, Yongheng, Wu, Aiwen, Cai, Yong, Wang, Weihu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7937798/
https://www.ncbi.nlm.nih.gov/pubmed/33692945
http://dx.doi.org/10.3389/fonc.2020.627572
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author Li, Shuai
Zhang, Yangzi
Yu, Yang
Zhu, Xianggao
Geng, Jianhao
Teng, Huajing
Wang, Zhilong
Sun, Tingting
Wang, Lin
Wang, Hongzhi
Li, Yongheng
Wu, Aiwen
Cai, Yong
Wang, Weihu
author_facet Li, Shuai
Zhang, Yangzi
Yu, Yang
Zhu, Xianggao
Geng, Jianhao
Teng, Huajing
Wang, Zhilong
Sun, Tingting
Wang, Lin
Wang, Hongzhi
Li, Yongheng
Wu, Aiwen
Cai, Yong
Wang, Weihu
author_sort Li, Shuai
collection PubMed
description BACKGROUND AND PURPOSE: The optimal treatment modality for clinically positive lateral pelvic lymph node (LPLN) from locally advanced rectal cancer (LARC) is unknown. Thus, we aimed to analyze the optimal radiotherapy dose for clinically positive LPLN from LARC. MATERIALS AND METHODS: We retrospectively evaluated distal LARC (i.e., within 8 cm from the anal verge) patients with clinically positive LPLN (i.e., ≥7 mm in the short axis). They were divided into two groups based on whether or not they received simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT)–based chemoradiotherapy. The total radiotherapy dose on LPLN were 56-60Gy for SIB-IMRT group and 41.8Gy for non-SIB-IMRT group. The clinical parameters and regrowth rate of LPLN were then compared between the two groups. RESULTS: A total of 151 patients were evaluated, and 83 and 68 patients were classified to the SIB-IMRT and non-SIB-IMRT group, respectively. The median follow-up period was 22.6 months, and the 2-year LPLN regrowth rate was significantly different between the SIB-IMRT group and the non-SIB-IMRT group (0% vs 10.8%, P=0.024). Further, SIB-IMRT yielded a significantly lower 2-year LPLN regrowth rate in patients whose LPLN measured ≥8 mm in the short axis (0% vs. 15.9%, P=0.019) or ≥10 mm in the long axis (0% vs. 17.6%, P=0.024) compared to patients who were in non-SIB-IMRT group. Meanwhile, there was no significant difference in grade II radiation-related toxicity (30.1% vs. 39.1%, P=0.217) and surgical complications (21.8% vs. 12.2%, P=0.198) between the two groups. CONCLUSION: SIB-IMRT–based neoadjuvant chemoradiotherapy is beneficial for eliminating clinically positive LPLN from LARC without increasing the incidence of radiotherapy-related toxicity and surgical complications, and patients with larger LPLN may gain benefit from this technique.
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spelling pubmed-79377982021-03-09 Simultaneous Integrated Boost Intensity-Modulated Radiation Therapy Can Benefit the Locally Advanced Rectal Cancer Patients With Clinically Positive Lateral Pelvic Lymph Node Li, Shuai Zhang, Yangzi Yu, Yang Zhu, Xianggao Geng, Jianhao Teng, Huajing Wang, Zhilong Sun, Tingting Wang, Lin Wang, Hongzhi Li, Yongheng Wu, Aiwen Cai, Yong Wang, Weihu Front Oncol Oncology BACKGROUND AND PURPOSE: The optimal treatment modality for clinically positive lateral pelvic lymph node (LPLN) from locally advanced rectal cancer (LARC) is unknown. Thus, we aimed to analyze the optimal radiotherapy dose for clinically positive LPLN from LARC. MATERIALS AND METHODS: We retrospectively evaluated distal LARC (i.e., within 8 cm from the anal verge) patients with clinically positive LPLN (i.e., ≥7 mm in the short axis). They were divided into two groups based on whether or not they received simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT)–based chemoradiotherapy. The total radiotherapy dose on LPLN were 56-60Gy for SIB-IMRT group and 41.8Gy for non-SIB-IMRT group. The clinical parameters and regrowth rate of LPLN were then compared between the two groups. RESULTS: A total of 151 patients were evaluated, and 83 and 68 patients were classified to the SIB-IMRT and non-SIB-IMRT group, respectively. The median follow-up period was 22.6 months, and the 2-year LPLN regrowth rate was significantly different between the SIB-IMRT group and the non-SIB-IMRT group (0% vs 10.8%, P=0.024). Further, SIB-IMRT yielded a significantly lower 2-year LPLN regrowth rate in patients whose LPLN measured ≥8 mm in the short axis (0% vs. 15.9%, P=0.019) or ≥10 mm in the long axis (0% vs. 17.6%, P=0.024) compared to patients who were in non-SIB-IMRT group. Meanwhile, there was no significant difference in grade II radiation-related toxicity (30.1% vs. 39.1%, P=0.217) and surgical complications (21.8% vs. 12.2%, P=0.198) between the two groups. CONCLUSION: SIB-IMRT–based neoadjuvant chemoradiotherapy is beneficial for eliminating clinically positive LPLN from LARC without increasing the incidence of radiotherapy-related toxicity and surgical complications, and patients with larger LPLN may gain benefit from this technique. Frontiers Media S.A. 2021-02-22 /pmc/articles/PMC7937798/ /pubmed/33692945 http://dx.doi.org/10.3389/fonc.2020.627572 Text en Copyright © 2021 Li, Zhang, Yu, Zhu, Geng, Teng, Wang, Sun, Wang, Wang, Li, Wu, Cai and Wang https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Li, Shuai
Zhang, Yangzi
Yu, Yang
Zhu, Xianggao
Geng, Jianhao
Teng, Huajing
Wang, Zhilong
Sun, Tingting
Wang, Lin
Wang, Hongzhi
Li, Yongheng
Wu, Aiwen
Cai, Yong
Wang, Weihu
Simultaneous Integrated Boost Intensity-Modulated Radiation Therapy Can Benefit the Locally Advanced Rectal Cancer Patients With Clinically Positive Lateral Pelvic Lymph Node
title Simultaneous Integrated Boost Intensity-Modulated Radiation Therapy Can Benefit the Locally Advanced Rectal Cancer Patients With Clinically Positive Lateral Pelvic Lymph Node
title_full Simultaneous Integrated Boost Intensity-Modulated Radiation Therapy Can Benefit the Locally Advanced Rectal Cancer Patients With Clinically Positive Lateral Pelvic Lymph Node
title_fullStr Simultaneous Integrated Boost Intensity-Modulated Radiation Therapy Can Benefit the Locally Advanced Rectal Cancer Patients With Clinically Positive Lateral Pelvic Lymph Node
title_full_unstemmed Simultaneous Integrated Boost Intensity-Modulated Radiation Therapy Can Benefit the Locally Advanced Rectal Cancer Patients With Clinically Positive Lateral Pelvic Lymph Node
title_short Simultaneous Integrated Boost Intensity-Modulated Radiation Therapy Can Benefit the Locally Advanced Rectal Cancer Patients With Clinically Positive Lateral Pelvic Lymph Node
title_sort simultaneous integrated boost intensity-modulated radiation therapy can benefit the locally advanced rectal cancer patients with clinically positive lateral pelvic lymph node
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7937798/
https://www.ncbi.nlm.nih.gov/pubmed/33692945
http://dx.doi.org/10.3389/fonc.2020.627572
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