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©The Author(s) 2021.
World J Gastrointest Oncol. Apr 15, 2021; 13(4): 252-264
Published online Apr 15, 2021. doi: 10.4251/wjgo.v13.i4.252
Published online Apr 15, 2021. doi: 10.4251/wjgo.v13.i4.252
Table 5 Summaries of studies on neoadjuvant chemotherapy followed by chemoradiotherapy
Study | Design | n | Eligibility | NAC regimen | CRT regimen | AC regimen | Response | Compliance | Recurrence | Survival |
Chau et al[3] | Prospective single-arm | 36 | cT3N0-2; cT4N0-2 | MMC (× 2); PVI 5-FU | RT 54Gy/30Fx’s; PVI 5-FU | MMC; PVI 5-FU | 27.8%1 after NAC; 80.6%1 after CRT | NAC 100%; CRT 100% | LR 2 pts; DM 9 pts | 1Y-OS 93.5%; 2Y-OS 70.3% |
EXPERT[4,5] | Phase II single-arm | 105 | MR defined disease: MRF involved or threatened, cT3 tumor at or below the levators, cT4, cN2, extramural extension ≥ 5 mm | CAPOX (× 4) | RT 54Gy/30Fx’s; capecitabine | capecitabine | 74%1 after NAC; 89%1 after CRT | NAC 89%; CRT 91% | LR 6 pts; DM 21 pts | 5Y-OS 75.0% |
GCR-3[6,7] | Phase II; RCT | 54 | MR defined disease: Distal edge within 12 cm from AV, lower third cT3, resectable cT4, cT3-4N+, MRF involved or threatened | CAPOX (× 4) | RT 54Gy/27Fx’s; CAPOX | - | Downstaging 43.0%; pCR 14.0% | NAC 94.0%; CRT 85.0% | LR 5%; DM 23% | 5Y-OS 75.0% |
49 | - | RT 54Gy/27Fx’s; CAPOX | CAPOX (× 4) | Downstaging 58.0%; pCR 13.0% | CRT 80.0%; AC 57.0% | LR 2%; DM 21% | 5Y-OS 78.0% | |||
Phase II single-arm | 60 | Inferior margin ≥ 4 cm from AV, superior margin < S1/2 interspace, tumor > 1 mm from MRF, cT3d, cT4, mrT3a-b with either EMV invasion or mesorectal lymph nodes | Oxaliplatin/5-FU (× 4) | RT 25Gy/5Fx’s | Oxaliplatin 5-FU (× 8) | T down staging: 73.0%1 after NAC; 74.0% after surgery | NAC 75.0%; AC 37.0% | LR 2 pts; DM 6 pts | 2Y-PFS 86.2% | |
CONTRE[9] | Prospective single-arm | 39 | cT3-4N0, cT1-4N+ | mFOLFOX6 (× 8) | RT 50.4Gy/28Fx’s capecitabine | - | pCR 33.0% | NAC 92.0% | LR 2 pts; DM 6 pts | - |
Schou et al[10] | Prospective single-arm | 84 | MR defined disease: MRF involved or threatened, cT3-4 N+ | CAPOX (× 2) | RT 54Gy/27Fx’scapecitabine | - | T down staging 69% after surgerypCR 23.0% | NAC 88.0% | LR 1%DM 25% | 5Y-OS 67.0% |
Dueland et al[11] | Prospective single-arm | 97 | cT3 with < 3 mm from MRF, cT4, N+, resectable synchronous metastasis | Nordic FLOX (× 2) | RT 50Gy/25Fx’s; CAPOX | - | pCR 17.3% | NAC 91.0% | LR 4 pts; DM 27 pts | 5Y-OS 83.0% |
Koeberle et al[12] | Phase II single-arm | 60 | cT3-4 with N- or N+ | CAPOX (× 1) | RT 45Gy/25Fx’s; CAPOX | - | pCR 23.0% | Oxaliplatin 87.0% | - | - |
Maréchal et al[13] | Phase II RCT | 29 | cT2-4, cN+ | - | RT 45Gy/25Fx’s; 5-FU | - | pCR 28% | NAC 96.0%; CRT 98.0% | - | - |
28 | mFOLFOX6 (× 2) | RT 45Gy/25Fx’s; 5-FU | - | pCR 25% | ||||||
EXPERT-C[14] | Phase II RCT | 81 | MR defined disease: Tumor within 1mm of MRF, cT3 tumor at or below the levators, cT4, presence of EMV invasion, extramural extension5mm | CAPOX (× 4) cetuximab | RT 54Gy/30Fx’s; capecitabine/ cetuximab | CAPOX (× 4); cetuximab | 64.0%1 after NAC; 84.0%1 after CRT | NAC 95.0%; CRT 91.0% | LR 1 pt | - |
83 | CAPOX (× 4) | RT 54Gy/30Fx’s; capecitabine | CAPOX (x4) | 54.0%1 after NAC; 76.0%1 after CRT | NAC 93.0%; CRT 90.0% | LR 2 pts | - | |||
AVACROSS[15] | Phase II single-arm | 47 | Distal edge ≤ 1 cm from AV, cT3N+, resectable cT4, cT3 tumor in lower third, tumor in middle third with ≤ 2 mm from MRF, N+ with ≤ 2 mm from MRF | CAPOX/bevacizumab (× 4) | RT 50Gy/25Fx’s; capecitabine/ bevacizumab | CAPOX (x4) | pCR 34.0% | NAC 85.0%; CRT 83.0% | DM 5 pts | - |
Eisterer et al[16] | Phase II single-arm | 25 | MR defined disease: cT3 (< 5 mm from MRF), cT4 | CAPOX/bevacizumab (× 3) | RT 45Gy/25Fx’s capecitabine | - | pCR 25.0% | NAC 79.2%CRT 94.7% | - | - |
PRODIGE23[31] | Phase III | 231 | cT3-4 | mFOLFIRINOX (× 6) | RT 50Gy25Fx’s; capecitabine | mFOLFOX6 or capecitabine | pCR 27.8% | - | - | 3Y-DFS 75.7% |
230 | - | pCR 12% | - | - | 3Y-DFS 68.5% |
- Citation: Park H. Predictive factors for early distant metastasis after neoadjuvant chemoradiotherapy in locally advanced rectal cancer. World J Gastrointest Oncol 2021; 13(4): 252-264
- URL: https://www.wjgnet.com/1948-5204/full/v13/i4/252.htm
- DOI: https://dx.doi.org/10.4251/wjgo.v13.i4.252