Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Simultaneous integrated boost intensity-modulated radiotherapy versus 3-dimensional conformal radiotherapy in preoperative concurrent chemoradiotherapy for locally advanced rectal cancer

  • Bae, Bong Kyung (Department of Radiation Oncology, Kyungpook National University School of Medicine) ;
  • Kang, Min Kyu (Department of Radiation Oncology, Kyungpook National University School of Medicine) ;
  • Kim, Jae-Chul (Department of Radiation Oncology, Kyungpook National University School of Medicine) ;
  • Kim, Mi Young (Department of Radiation Oncology, Kyungpook National University Chilgok Hospital) ;
  • Choi, Gyu-Seog (Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine) ;
  • Kim, Jong Gwang (Department of Oncology/Hematology, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine) ;
  • Kang, Byung Woog (Department of Oncology/Hematology, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine) ;
  • Kim, Hye Jin (Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine) ;
  • Park, Soo Yeun (Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine)
  • Received : 2017.07.06
  • Accepted : 2017.07.31
  • Published : 2017.09.30
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Abstract

Purpose: To evaluate the feasibility of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) for preoperative concurrent chemoradiotherapy (PCRT) in locally advanced rectal cancer (LARC), by comparing with 3-dimensional conformal radiotherapy (3D-CRT). Materials and Methods: Patients who were treated with PCRT for LARC from 2015 January to 2016 December were retrospectively enrolled. Total doses of 45 Gy to 50.4 Gy with 3D-CRT or SIB-IMRT were administered concomitantly with 5-fluorouracil plus leucovorin or capecitabine. Surgery was performed 8 weeks after PCRT. Between PCRT and surgery, one cycle of additional chemotherapy was administered. Pathologic tumor responses were compared between SIB-IMRT and 3D-CRT groups. Acute gastrointestinal, genitourinary, hematologic, and skin toxicities were compared between the two groups based on the RTOG toxicity criteria. Results: SIB-IMRT was used in 53 patients, and 3D-CRT in 41 patients. After PCRT, no significant differences were noted in tumor responses, pathologic complete response (9% vs. 7%; p = 1.000), pathologic tumor regression Grade 3 or higher (85% vs. 71%; p = 0.096), and R0 resection (87% vs. 85%; p = 0.843). Grade 2 genitourinary toxicities were significantly lesser in the SIB-IMRT group (8% vs. 24%; p = 0.023), but gastrointestinal toxicities were not different across the two groups. Conclusion: SIB-IMRT showed lower GU toxicity and similar tumor responses when compared with 3D-CRT in PCRT for LARC.

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References

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