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- Title
Comparison of volumetric-modulated arc therapy using simultaneous integrated boosts (SIB-VMAT) of 45 Gy/55 Gy in 25 fractions with conventional radiotherapy in preoperative chemoradiation for rectal cancers: a propensity score case-matched analysis.
- Authors
Hideomi Yamashita; Soichiro Ishihara; Hiroaki Nozawa; Kazushige Kawai; Tomomichi Kiyomatsu; Kae Okuma; Osamu Abe; Toshiaki Watanabe; Keiichi Nakagawa; Yamashita, Hideomi; Ishihara, Soichiro; Nozawa, Hiroaki; Kawai, Kazushige; Kiyomatsu, Tomomichi; Okuma, Kae; Abe, Osamu; Watanabe, Toshiaki; Nakagawa, Keiichi
- Abstract
<bold>Background and Purpose: </bold>The aim of this retrospective study was to compare volumetric-modulated arc therapy using simultaneous integrated boosts (SIB-VMAT) of 45 Gy/55 Gy in 25 fractions with three-dimensional conformal radiotherapy (3D-CRT) in preoperative chemoradiation for rectal cancers.<bold>Methods and Materials: </bold>In the propensity score-matching analysis of 1:2, we selected 60 patients from the SIB-VMAT group and 120patients from the 3D-CRT group matched pairings out of 145 patients between 2005 and 2015. The regimen of concurrent combined chemotherapy was oral uracil/tegafur plus leucovorin with/without irinotecan.<bold>Results: </bold>There were no significant differences between the two groups, in pathological complete response rates (pCR) (11% in the 3D-CRT group vs. 17% in the SIB-VMAT group, P = 0.39), pathological response rates (44% vs. 60%, P = 0.77), disease-free survival (P = 0.32), or local control (P = 0.52). The SIB-VMAT method marginally improved the rate of pathological grade 2-3 effects and the OS was significantly better in patients with grade 2-3 effects. Recurrence was seen in 36 patients (30%) in the 3D-CRT group and 19 patients (32%) in the SIB-VMAT group. The first distant recurrence site in the SIB-VMAT group was liver in 6 patients and lung in 8 patients. The obvious radiation-induced late toxicity in the SIB-VMAT group was recto-vesical fistula in two patients.<bold>Conclusions: </bold>The SIB-VMAT may be a promising method for preoperative CRT of rectal cancer.
- Subjects
VOLUMETRIC-modulated arc therapy; INTENSITY modulated radiotherapy; RADIOTHERAPY; RECTAL cancer patients; RECTAL cancer treatment; ADENOCARCINOMA; ANTINEOPLASTIC agents; COMBINED modality therapy; COMPARATIVE studies; RESEARCH methodology; MEDICAL cooperation; COMPUTERS in medicine; PROBABILITY theory; PROGNOSIS; RADIATION doses; RECTUM tumors; RESEARCH; EVALUATION research; TREATMENT effectiveness; RETROSPECTIVE studies; KAPLAN-Meier estimator
- Publication
Radiation Oncology, 2017, Vol 12, p1
- ISSN
1748-717X
- Publication type
journal article
- DOI
10.1186/s13014-017-0894-9