Clinical verification of sensitivity to neoadjuvant chemoradiotherapy in cases of locally advanced rectal cancer / 中国实用外科杂志

ABSTRACT

OBJECTIVE: To identify the influencing factors of pathologic complete response(pCR) after neoadjuvant chemoradiotherapy(nCRT) for rectal cancer.METHODS: The clinical data of 185 locally advanced rectal cancer patients admitted at the Sixth Affiliated Hospital Sun Yat-sen University between January 2013 and October 2016 were analyzed retrospectively. Patients were divided into two groups according to their responses to neoadjuvant therapy: the pCR(49 patients)and non-pCR groups(136 patients). The correlation between clinicopathological factors and PCR was analyzed.RESULTS:The rate of pathologic complete response(pCR) was 26.5%,and downstaging rate(ypStage 0 to 1)was achieved 55.8%. In univariate analyses,carcinoembryonic antigen concentration(P=0.039),clinical stage T(P=0.004),stage N(P=0.032)and neoadjuvant chemoradiotherapy with oxaliplatin(P=0.003)were significantly associated with pCR. In multivariate analysis,clinical stage T2 and neoadjuvant chemoradiotherapy with oxaliplatin were significantly associated with pCR,while CEA level was a marginally significant risk factor.CONCLUSION: Stage T2 cancer and fluorouracil-based neoadjuvant chemoradiotherapy with oxaliplatin are independent clinical predictors for achieving pCR.