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The Survival Effect of Radiotherapy on Stage II/III Rectal Cancer in Different Age Groups: Formulating Radiotherapy Decision-Making Based on Age

INTRODUCTION: Total mesorectal excision (TME), chemotherapy (CT), and radiotherapy (RT) are usually integrated into the comprehensive treatment of stage II/III rectal cancer (RC). Neoadjuvant radiotherapy (nRT) has become the standard treatment for stage II/III RC patients to help reduce the size of...

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Autores principales: Li, Yuqiang, Liu, Heli, Zhou, Yuan, Zhou, Zhongyi, Liu, Wenxue, Zhao, Lilan, Güngör, Cenap, Wang, Dan, Pei, Qian, Pei, Haiping, Tan, Fengbo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8356670/
https://www.ncbi.nlm.nih.gov/pubmed/34395261
http://dx.doi.org/10.3389/fonc.2021.695640
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author Li, Yuqiang
Liu, Heli
Zhou, Yuan
Zhou, Zhongyi
Liu, Wenxue
Zhao, Lilan
Güngör, Cenap
Wang, Dan
Pei, Qian
Pei, Haiping
Tan, Fengbo
author_facet Li, Yuqiang
Liu, Heli
Zhou, Yuan
Zhou, Zhongyi
Liu, Wenxue
Zhao, Lilan
Güngör, Cenap
Wang, Dan
Pei, Qian
Pei, Haiping
Tan, Fengbo
author_sort Li, Yuqiang
collection PubMed
description INTRODUCTION: Total mesorectal excision (TME), chemotherapy (CT), and radiotherapy (RT) are usually integrated into the comprehensive treatment of stage II/III rectal cancer (RC). Neoadjuvant radiotherapy (nRT) has become the standard treatment for stage II/III RC patients to help reduce the size of a tumor or kill cancer cells that have spread. Adjuvant RT is delivered after the resection to destroy remaining cancer cells and used mainly in stage II/III RC patients who have not received preoperative radiotherapy, such as those who suffered from a bowel obstruction before surgery. It is controversial whether radiotherapy can improve the survival of stage II/III RC patients. An increasing number of studies have reported that rectal cancer exhibited mismatched biology, epidemiology, and therapeutic response to current treatment strategy in different age groups. It is necessary to investigate whether radiotherapy exhibits disparate effects in different age groups of patients with stage II/III RC. METHODS: Data from the Surveillance, Epidemiology, and End Results (SEER) Program was extracted to identify stage II/III RC diagnosed in the periods of 2004–2016. The statistical methods included Pearson’s chi-square test, log-rank test, Cox regression model, and propensity score matching. RESULTS: Neoadjuvant radiotherapy (nRT) cannot improve the prognosis, and postoperative RT may even reduce the survival time for early onset stage II/III RC. Postoperative RT was not able to improve the overall survival (OS), while nRT may provide limited survival improvement for middle-aged stage II/III RC patients. In addition, radiotherapy can significantly improve the prognosis for elderly stage II/III RC. CONCLUSIONS: This study indicated the inconsistent survival effect of radiotherapy on stage II/III rectal cancer patients in different age groups. Hence, we formulated a novel flow chart of radiotherapy decision-making based on age in stage II/III RC patients.
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spelling pubmed-83566702021-08-12 The Survival Effect of Radiotherapy on Stage II/III Rectal Cancer in Different Age Groups: Formulating Radiotherapy Decision-Making Based on Age Li, Yuqiang Liu, Heli Zhou, Yuan Zhou, Zhongyi Liu, Wenxue Zhao, Lilan Güngör, Cenap Wang, Dan Pei, Qian Pei, Haiping Tan, Fengbo Front Oncol Oncology INTRODUCTION: Total mesorectal excision (TME), chemotherapy (CT), and radiotherapy (RT) are usually integrated into the comprehensive treatment of stage II/III rectal cancer (RC). Neoadjuvant radiotherapy (nRT) has become the standard treatment for stage II/III RC patients to help reduce the size of a tumor or kill cancer cells that have spread. Adjuvant RT is delivered after the resection to destroy remaining cancer cells and used mainly in stage II/III RC patients who have not received preoperative radiotherapy, such as those who suffered from a bowel obstruction before surgery. It is controversial whether radiotherapy can improve the survival of stage II/III RC patients. An increasing number of studies have reported that rectal cancer exhibited mismatched biology, epidemiology, and therapeutic response to current treatment strategy in different age groups. It is necessary to investigate whether radiotherapy exhibits disparate effects in different age groups of patients with stage II/III RC. METHODS: Data from the Surveillance, Epidemiology, and End Results (SEER) Program was extracted to identify stage II/III RC diagnosed in the periods of 2004–2016. The statistical methods included Pearson’s chi-square test, log-rank test, Cox regression model, and propensity score matching. RESULTS: Neoadjuvant radiotherapy (nRT) cannot improve the prognosis, and postoperative RT may even reduce the survival time for early onset stage II/III RC. Postoperative RT was not able to improve the overall survival (OS), while nRT may provide limited survival improvement for middle-aged stage II/III RC patients. In addition, radiotherapy can significantly improve the prognosis for elderly stage II/III RC. CONCLUSIONS: This study indicated the inconsistent survival effect of radiotherapy on stage II/III rectal cancer patients in different age groups. Hence, we formulated a novel flow chart of radiotherapy decision-making based on age in stage II/III RC patients. Frontiers Media S.A. 2021-07-28 /pmc/articles/PMC8356670/ /pubmed/34395261 http://dx.doi.org/10.3389/fonc.2021.695640 Text en Copyright © 2021 Li, Liu, Zhou, Zhou, Liu, Zhao, Güngör, Wang, Pei, Pei and Tan 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, Yuqiang
Liu, Heli
Zhou, Yuan
Zhou, Zhongyi
Liu, Wenxue
Zhao, Lilan
Güngör, Cenap
Wang, Dan
Pei, Qian
Pei, Haiping
Tan, Fengbo
The Survival Effect of Radiotherapy on Stage II/III Rectal Cancer in Different Age Groups: Formulating Radiotherapy Decision-Making Based on Age
title The Survival Effect of Radiotherapy on Stage II/III Rectal Cancer in Different Age Groups: Formulating Radiotherapy Decision-Making Based on Age
title_full The Survival Effect of Radiotherapy on Stage II/III Rectal Cancer in Different Age Groups: Formulating Radiotherapy Decision-Making Based on Age
title_fullStr The Survival Effect of Radiotherapy on Stage II/III Rectal Cancer in Different Age Groups: Formulating Radiotherapy Decision-Making Based on Age
title_full_unstemmed The Survival Effect of Radiotherapy on Stage II/III Rectal Cancer in Different Age Groups: Formulating Radiotherapy Decision-Making Based on Age
title_short The Survival Effect of Radiotherapy on Stage II/III Rectal Cancer in Different Age Groups: Formulating Radiotherapy Decision-Making Based on Age
title_sort survival effect of radiotherapy on stage ii/iii rectal cancer in different age groups: formulating radiotherapy decision-making based on age
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8356670/
https://www.ncbi.nlm.nih.gov/pubmed/34395261
http://dx.doi.org/10.3389/fonc.2021.695640
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