Pelvic radiotherapy followed by systemic therapy and surgery improves survival in patients with advanced rectal cancer

This study investigated the effectiveness of pelvic radiotherapy (PRT) followed by chemotherapy and surgery in advanced rectal cancer. Researchers suggested that this combined treatment is associated with improved survival rates.

Rectal cancer affects 44,180 people each year in the US. Up to 80% of these people present with inoperable liver metastasis (cancer spread to the liver) at diagnosis. Surgery to more than one tumor site is challenging. Therefore, the standard treatment used to be long-course chemotherapy and PRT. However, this has only a limited effect on distant metastasis.

Therefore, a new treatment program was introduced. It consisted of short-course PRT to the first tumor and chemotherapy to address the metastatic tumor. Patients who had tumor shrinkage can then receive surgery. The outcomes of patients with advanced rectal cancer receiving this treatment sequence are still unknown.

This study included 169 patients with stage 4 rectal cancer and liver metastasis. These patients received short-course PRT followed by chemotherapy and surgery with or without other local therapies.

65.7% of these patients completed the treatment. The average follow-up was 49.5 months. Overall survival and progression-free survival (PFS; time from treatment to disease progression) were measured.

3-year PFS was 24.2% and 3-year overall survival was 48.8%. The average overall survival of patients who responded well and completed the treatment was 51.5 months. For patients who did not complete the treatment, the average overall survival was 15.1 months.  

Adequate management of the primary tumor symptoms was achieved in 87% of all patients.

This study concluded that short-course PRT followed by chemotherapy and tumor surgery is associated with improved survival rates in stage advanced rectal cancer.

This study was based on medical records. Some information might have been missing.