Short-term and long-term oncological outcomes of chemoradiotherapy for rectal cancer patients with or without oxaliplatin: a propensity score-matched retrospective analysis
Abstract Background/Aim Current approaches for locally advanced rectal cancer (LARC) typically recommend neoadjuvant chemoradiotherapy (nCRT) with 5-fluorouracil (5FU) or its oral analogs followed by surgery as the standard of care. However, the question of whether intensifying concurrent chemothera...
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BMC
2024-12-01
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| Series: | Radiation Oncology |
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| Online Access: | https://doi.org/10.1186/s13014-024-02562-y |
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| author | Amirali Azimi Fatemeh Sadat Tabatabaei Kasra Kolahdouzan Hamideh Rashidian Forouzan Nourbakhsh Maryam Abedini Parizi Nima Mousavi Darzikolaee Reyhaneh Bayani Samaneh Salarvand Azadeh Sharifian Farzaneh Bagheri Saeed Rezaei Naeim Nabian Reza Nazari Negin Mohammadi Mohammad Babaei Marzieh Lashkari Farshid Farhan Mahdi Aghili Felipe Couñago Maria Antonietta Gambacorta Reza Ghalehtaki |
| author_facet | Amirali Azimi Fatemeh Sadat Tabatabaei Kasra Kolahdouzan Hamideh Rashidian Forouzan Nourbakhsh Maryam Abedini Parizi Nima Mousavi Darzikolaee Reyhaneh Bayani Samaneh Salarvand Azadeh Sharifian Farzaneh Bagheri Saeed Rezaei Naeim Nabian Reza Nazari Negin Mohammadi Mohammad Babaei Marzieh Lashkari Farshid Farhan Mahdi Aghili Felipe Couñago Maria Antonietta Gambacorta Reza Ghalehtaki |
| author_sort | Amirali Azimi |
| collection | DOAJ |
| description | Abstract Background/Aim Current approaches for locally advanced rectal cancer (LARC) typically recommend neoadjuvant chemoradiotherapy (nCRT) with 5-fluorouracil (5FU) or its oral analogs followed by surgery as the standard of care. However, the question of whether intensifying concurrent chemotherapy by adding oxaliplatin to the 5FU-based backbone can yield better outcomes remains unresolved. This study aimed to investigate the benefits of incorporating oxaliplatin into fluoropyrimidine-based chemoradiotherapy (CRT) to increase locoregional control and survival. Methods Among 290 patients with LARC admitted to the Iran Cancer Institute’s radiation oncology department between January 2008 and December 2019, 29 received CAPEOX (capecitabine 625 mg/m²/bid on RT days and weekly oxaliplatin 50 mg/m²), whereas 293 received capecitabine (825 mg/m² twice daily or rarely 5FU in the first 4 days and last week of radiotherapy (RT)). Variables potentially affecting treatment outcomes were used for propensity score matching. Kaplan‒Meier and log-rank tests were employed for overall survival (OS) and disease-free survival (DFS) analyses and were adjusted with propensity score matching. Results Data from 29 patients who received CAPEOX and 216 patients who received capecitabine were analyzed after propensity score matching without replacement. After propensity score matching, in the multivariate analysis, CAPEOX significantly increased the likelihood of achieving a pathologic complete response (pCR) by 4.38 times (CI: 1.90–10.08, p value < 0.001). However, CAPEOX did not demonstrate any statistically significant predictive value for DFS (P = 0.500) or OS (P = 0.449). Conclusion The addition of oxaliplatin resulted in a significantly higher rate of pCR without any translation into long-term survival outcomes. |
| format | Article |
| id | doaj-art-6bf7f5612e68425fbc22233e70cfe959 |
| institution | Kabale University |
| issn | 1748-717X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
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| series | Radiation Oncology |
| spelling | doaj-art-6bf7f5612e68425fbc22233e70cfe9592024-12-08T12:38:54ZengBMCRadiation Oncology1748-717X2024-12-0119111110.1186/s13014-024-02562-yShort-term and long-term oncological outcomes of chemoradiotherapy for rectal cancer patients with or without oxaliplatin: a propensity score-matched retrospective analysisAmirali Azimi0Fatemeh Sadat Tabatabaei1Kasra Kolahdouzan2Hamideh Rashidian3Forouzan Nourbakhsh4Maryam Abedini Parizi5Nima Mousavi Darzikolaee6Reyhaneh Bayani7Samaneh Salarvand8Azadeh Sharifian9Farzaneh Bagheri10Saeed Rezaei11Naeim Nabian12Reza Nazari13Negin Mohammadi14Mohammad Babaei15Marzieh Lashkari16Farshid Farhan17Mahdi Aghili18Felipe Couñago19Maria Antonietta Gambacorta20Reza Ghalehtaki21Radiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical SciencesRadiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical SciencesDepartment of Radiation Oncology, Cancer Institute, School of Medicine, IKHC, Tehran University of Medical SciencesCancer Research Center, Cancer Research Institute, Tehran University of Medical SciencesRadiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical SciencesRadiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical SciencesDepartment of Radiation Oncology, Cancer Institute, School of Medicine, IKHC, Tehran University of Medical SciencesDepartment of Radiation Oncology, Cancer Institute, School of Medicine, IKHC, Tehran University of Medical SciencesDepartment of Anatomical and Clinical Pathology, School of Medicine, IKHC, Tehran University of Medical SciencesRadiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical SciencesRadiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical SciencesRadiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical SciencesRadiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical SciencesRadiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical SciencesRadiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical SciencesRadiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical SciencesRadiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical SciencesDepartment of Radiation Oncology, Cancer Institute, School of Medicine, IKHC, Tehran University of Medical SciencesRadiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical SciencesDepartment of Radiation Oncology, Hospital Universitario Vithas Madrid La MilagrosaDepartment of Radiology, Radiation Oncology and Hematology, Catholic University of the Sacred Heart, Agostino Gemelli University Hospital Foundation IRCCSRadiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical SciencesAbstract Background/Aim Current approaches for locally advanced rectal cancer (LARC) typically recommend neoadjuvant chemoradiotherapy (nCRT) with 5-fluorouracil (5FU) or its oral analogs followed by surgery as the standard of care. However, the question of whether intensifying concurrent chemotherapy by adding oxaliplatin to the 5FU-based backbone can yield better outcomes remains unresolved. This study aimed to investigate the benefits of incorporating oxaliplatin into fluoropyrimidine-based chemoradiotherapy (CRT) to increase locoregional control and survival. Methods Among 290 patients with LARC admitted to the Iran Cancer Institute’s radiation oncology department between January 2008 and December 2019, 29 received CAPEOX (capecitabine 625 mg/m²/bid on RT days and weekly oxaliplatin 50 mg/m²), whereas 293 received capecitabine (825 mg/m² twice daily or rarely 5FU in the first 4 days and last week of radiotherapy (RT)). Variables potentially affecting treatment outcomes were used for propensity score matching. Kaplan‒Meier and log-rank tests were employed for overall survival (OS) and disease-free survival (DFS) analyses and were adjusted with propensity score matching. Results Data from 29 patients who received CAPEOX and 216 patients who received capecitabine were analyzed after propensity score matching without replacement. After propensity score matching, in the multivariate analysis, CAPEOX significantly increased the likelihood of achieving a pathologic complete response (pCR) by 4.38 times (CI: 1.90–10.08, p value < 0.001). However, CAPEOX did not demonstrate any statistically significant predictive value for DFS (P = 0.500) or OS (P = 0.449). Conclusion The addition of oxaliplatin resulted in a significantly higher rate of pCR without any translation into long-term survival outcomes.https://doi.org/10.1186/s13014-024-02562-yRectal cancerOxaliplatinRadiotherapySurvivalNeoadjuvant therapy |
| spellingShingle | Amirali Azimi Fatemeh Sadat Tabatabaei Kasra Kolahdouzan Hamideh Rashidian Forouzan Nourbakhsh Maryam Abedini Parizi Nima Mousavi Darzikolaee Reyhaneh Bayani Samaneh Salarvand Azadeh Sharifian Farzaneh Bagheri Saeed Rezaei Naeim Nabian Reza Nazari Negin Mohammadi Mohammad Babaei Marzieh Lashkari Farshid Farhan Mahdi Aghili Felipe Couñago Maria Antonietta Gambacorta Reza Ghalehtaki Short-term and long-term oncological outcomes of chemoradiotherapy for rectal cancer patients with or without oxaliplatin: a propensity score-matched retrospective analysis Radiation Oncology Rectal cancer Oxaliplatin Radiotherapy Survival Neoadjuvant therapy |
| title | Short-term and long-term oncological outcomes of chemoradiotherapy for rectal cancer patients with or without oxaliplatin: a propensity score-matched retrospective analysis |
| title_full | Short-term and long-term oncological outcomes of chemoradiotherapy for rectal cancer patients with or without oxaliplatin: a propensity score-matched retrospective analysis |
| title_fullStr | Short-term and long-term oncological outcomes of chemoradiotherapy for rectal cancer patients with or without oxaliplatin: a propensity score-matched retrospective analysis |
| title_full_unstemmed | Short-term and long-term oncological outcomes of chemoradiotherapy for rectal cancer patients with or without oxaliplatin: a propensity score-matched retrospective analysis |
| title_short | Short-term and long-term oncological outcomes of chemoradiotherapy for rectal cancer patients with or without oxaliplatin: a propensity score-matched retrospective analysis |
| title_sort | short term and long term oncological outcomes of chemoradiotherapy for rectal cancer patients with or without oxaliplatin a propensity score matched retrospective analysis |
| topic | Rectal cancer Oxaliplatin Radiotherapy Survival Neoadjuvant therapy |
| url | https://doi.org/10.1186/s13014-024-02562-y |
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