Navigation Links
Long-term follow-up shows need for new chemotherapy strategies for rectal cancer
Date:1/22/2014

Appearing in Lancet Oncology, long term results of EORTC trial 22921 with 10.4 years median follow-up show that 5-FU (fluorouracil) based adjuvant chemotherapy after preoperative (chemo)-radiotherapy for patients with cT3-resectable T4 M0 rectal cancer does not improve survival or disease-free survival.

EORTC trial 22921 explored the value of adding chemotherapy to preoperative radiotherapy either concurrently, or as an adjuvant, or both for patients with cT3-resectable T4 M0 rectal cancer. Between April 1993 and March 2003, 1011 patients were randomized to four treatment arms, 252 patients received preoperative radiotherapy alone, 253 patients received preoperative radiotherapy - chemotherapy, 253 patients received preoperative radiotherapy followed by adjuvant chemotherapy, and 253 patients received preoperative radiotherapy and chemotherapy followed by adjuvant chemotherapy.

Prof. Jean-Franois Bosset of the CHRU de Besancon - Hopital Jean Minjoz in France and lead author of this study says, "When we looked at the results after five years median follow-up, we saw that chemotherapy, regardless of when it was administered, significantly improved local control. However, adjuvant chemotherapy did not improve survival or disease-free survival, but we noted that the curves by adjuvant treatment did diverge progressively starting from year four for overall survival and from year two for disease-free survival. This suggested a possible delayed benefit, and we wanted to resolve this. The long term follow-up results suggest that new treatment strategies incorporating neoadjuvant chemotherapy are required, because adjuvant chemotherapy does not demonstrate any significant long term benefit on overall survival or disease-free survival."

Results of EORTC trial 22921 show that compliance with adjuvant chemotherapy was poor, and only 42.9%of the patients received the planned dose within the scheduled time frame. The 10-year overall survival rates were 51.8% (CI 47.0-56.4) for the patients receiving adjuvant chemotherapy and 48.4% (95% CI 43.6-53.0%) for those in the surveillance groups (HR=0.91, 95% CI 0.77-1.09, p=0.32). The 10-year disease free survival rates were 47.0% (CI 42.2-51.6%) for the patients receiving adjuvant chemotherapy and 43.7% (CI 39.1-48.2%) for those in the surveillance groups (HR=0.91, 95% CI 0.77-1.08, p=0.29).

Most relapses occur within five years, and at ten years local relapse rates were 22.4% (CI 17.1-27.6) with radiotherapy alone, 11.8% (7.8-15.8%) with neoadjuvant radiotherapy-chemotherapy, 14.5% (10.1-18.9%) with radiotherapy and adjuvant chemotherapy, and 11.7% (7.7-15.6%) with both adjuvant and neoadjuvant chemotherapy (p=0.0017).

There was no difference in cumulative incidence of distant metastases (p=0.52). The frequency of long term side effects did not differ between the four groups (p=0.22).


'/>"/>

Contact: John Bean
john.bean@eortc.be
European Organisation for Research and Treatment of Cancer
Source:Eurekalert

Related medicine news :

1. Latest Research Shows Improved Long-Term Memory with Same Caffeine Level as 5-hour ENERGY® Shots
2. Ear tubes vs. watchful waiting: Tubes do not improve long-term development
3. Top 3 Benefits of Sex with a Long-Term Partner
4. Study shows symptoms linked to poor quality of life in long-term childhood
5. Bronchial thermoplasty shows long-term effectiveness for asthma
6. Congenital heart defects affects long-term developmental outcome
7. Imaging shows long-term impact of blast-induced brain injuries in veterans
8. Dr. Oz Show Discusses Long-term Side Effects of LASIK
9. PharmScript Offers Tips on How to Beat the Flu in Long-Term Care Communities
10. Long-term use of prescription-based painkillers increases the risk of depression, SLU researcher finds
11. Five-Year Follow-Up Data on CERAMENT™
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/22/2017)... ... June 22, 2017 , ... Groove Ring is excited to announce they've partnered ... silicon wedding bands and all-purpose rings. Whether you’re an athlete, adventurer, professional, or love ... for you. , From the rock face to the auto shop, Groove Ring is ...
(Date:6/22/2017)... ... June 22, 2017 , ... A June 12 article ... concerned about an apparent lack of oral hygiene by an aged parent who had ... dementia-related matters, suggests a number of steps, including scheduling a dentist visit. Northridge Dental ...
(Date:6/20/2017)... ... 2017 , ... After months of negotiations, FaceCradle USA is proud to announce the debut of ... , “Introducing our product on QVC is something we all worked hard to achieve for ... more than 90 million homes in the United States,” said FaceCradle USA President Dylan Doherty. ...
(Date:6/20/2017)... Boulder, CO (PRWEB) , ... June 20, 2017 ... ... released a report contending that the introduction of school choice can promote economic ... of a charter school that has, according to the report, contributed to the ...
(Date:6/20/2017)... Cincinnati, Ohio (PRWEB) , ... June 20, 2017 ... ... with gum disease in Cincinnati, OH for leading-edge care, whether or ... advances in laser dentistry. Using the BIOLASE WaterLase® iPlus™ laser, she targets bacteria ...
Breaking Medicine News(10 mins):
(Date:6/16/2017)... 16, 2017  Exactly 50 years ago today, the Monterey ... became known as the San Francisco "Summer of Love."  To ... two radical innovations in strategic market research portals that it ... the beginning of Northern Light,s "Summer of Love (For Our ... ...
(Date:6/12/2017)... Kineta, Inc., a biotechnology company focused on the ... President of R&D and Head of Virology Kristin Bedard has ... the Northwest and Beyond meeting sponsored by Life Science ... from 8:30-10:30 AM PDT at the Agora Conference Center in ... Bedard will be joined by other leaders in infectious disease ...
(Date:6/8/2017)... Fla. , June 8, 2017  Less than ... that hit more than 200,000 companies, including hospital networks, ... being heralded as one of the largest online extortion ... in the healthcare market, it is imperative that providers ... protect their data from this — and many other ...
Breaking Medicine Technology: