Nonoperative Management Following Complete Response in Rectal Cancer After Short-course Radiation Therapy and Consolidation Chemotherapy: Clinical Outcomes and Quality of Life Measures.

Abstract

PURPOSE:

The purpose of his study was to report on a cohort of patients managed with nonoperative management (NOM) with a watch-and-wait strategy after achieving complete response (CR) to sequential short-course radiation therapy (SCRT) and consolidation chemotherapy.

METHODS:

This was a retrospective study of patients treated SCRT and chemotherapy who achieved a CR and were managed with NOM. Bowel function was assessed with European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30, EORTC Quality of Life Questionnaire-Colorectal Cancer 29, and the low anterior resection syndrome (LARS) questionnaires. Endpoints included overall survival (OS), freedom from local failure (FFLF), freedom from distant metastasis, and disease-free survival (DFS).

RESULTS:

Twenty-six patients met inclusion criteria. Seven (26.9%) patients developed local failure at a median of 6.8 months following CR, of which 5 were successfully salvaged. Median FFLF was not reached, with 6-month, 1-, and 2-year FFLF rates of 100.0%, 82.3%, and 71.3%. Median OS was not reached, with 6-month, 1-, and 2-year OS rates of 100%. Median DFS was not reached, with 6-month, 1-, and 2-year DFS rates of 100%, 95.0%, and 89.4%. Questionnaire response rate was 83.3%. Median LARS score was 27. Major, minor, and no LARS occurred in 3 (20%), 6 (40%), and 6 (40%) patients, respectively. There were no differences in questionnaire scores between patients who had the majority of their anal sphincter complex irradiated and those who did not.

CONCLUSION:

NOM with a watch-and-wait strategy is safe and feasible in patients with locally advanced rectal cancer who achieve CR after sequential SCRT and chemotherapy, with evidence for good anorectal function.

• Authors: Abhinav V Reddy, Bashar Safar, Angela Y Jia, Nilofer S Azad, Eric S Christenson, Chady Atallah, Jonathan E Efron, Susan L Gearhart, Atif Zaheer, Amol K Narang, Jeffrey Meyer
• Journal: American journal of clinical oncology (Am J Clin Oncol) Vol. 45 Issue 7 Pg. 298-305 (07 01 2022) ISSN: 1537-453X [Electronic] United States
• PMID: 35700084 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

Topics

• Humans
• Neoadjuvant Therapy
• Postoperative Complications
• Quality of Life
• Rectal Neoplasms (pathology)
• Retrospective Studies
• Syndrome