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 CERAMENTâ„¢
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... , ... June 25, 2016 , ... As a lifelong ... Cum Laude and his M.D from the David Geffen School of Medicine at UCLA. ... to Los Angeles to complete his fellowship in hematology/oncology at the UCLA-Olive View-Cedars Sinai ...
(Date:6/25/2016)... ... June 25, 2016 , ... Conventional wisdom preaches the benefits ... terms of the latter, setting the bar too high can result in disappointment, perhaps ... slow progress toward their goal. , Research from PsychTests.com reveals that ...
(Date:6/24/2016)... ... 24, 2016 , ... June 19, 2016 is World Sickle Cell Observance Day. ... the benefits of holistic treatments, Serenity Recovery Center of Marne, Michigan, has ... , Sickle Cell Disease (SCD) is a disorder of the red blood cells, which ...
(Date:6/24/2016)... , ... June 24, 2016 , ... Global law firm ... 2016 Legal Elite. The attorneys chosen by their peers for this recognition are considered ... Seven Greenberg Traurig Shareholders received special honors as members of this year’s Legal Elite ...
(Date:6/24/2016)... , ... June 24, 2016 , ... Topical BioMedics, Inc, makers of Topricin and MyPainAway ... call for a minimum wage raise to $12 an hour by 2020 and then adjusting ... restore the lost value of the minimum wage, assure the wage floor does not erode ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... 23, 2016 Capricor Therapeutics, ... a biotechnology company focused on the discovery, development ... patient enrollment in its ongoing randomized HOPE-Duchenne clinical ... 50% of its 24-patient target. Capricor expects the ... quarter of 2016, and to report top line ...
(Date:6/23/2016)... PARK RIDGE, Ill. and INDIANAPOLIS ... caliber of students receiving a Lilly Diabetes Tomorrow,s Leaders ... hands. The 2016 scholarship winners, announced today online at ... refused to let type 1 diabetes stand in the ... Lilly Diabetes has supported the Foundation,s scholarship program since ...
(Date:6/23/2016)... -- The vast majority of dialysis patients currently receive ... usually 3 times a week, with treatment times averaging ... equipment preparation and wait time.  This regimen can be ... who are elderly and frail.  Many elderly dialysis patients ... for some duration of time. Residents in ...
Breaking Medicine Technology: