Case Control Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2021; 9(7): 1524-1531
Published online Mar 6, 2021. doi: 10.12998/wjcc.v9.i7.1524
Efficacy and safety of short duration radiotherapy combined with chemotherapy for advanced rectal cancer
Shu-Quan Gao, Ying-Chun Zhang, Chao Zhang, Sheng-Jie Wang, Wei Ren, Na Yuan, Jun-Ye Wen
Shu-Quan Gao, Ying-Chun Zhang, Sheng-Jie Wang, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075061, Hebei Province, China
Chao Zhang, Department of Interventional Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075061, Hebei Province, China
Wei Ren, Operating Room, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075061, Hebei Province, China
Na Yuan, Department of Radiotherapy, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075061, Hebei Province, China
Jun-Ye Wen, Department of General Surgery, Hebei Provincial People’s Hospital, Shijiazhuang 050003, Hebei Province, China
Author contributions: Gao SQ and Zhang YC designed the study; Gao SQ, Zhang YC, Zhang C, Wang SJ, Ren W, Yuan N and Wen JY collected the data and materials as well as analyzed the data; all authors wrote the manuscript; Gao SQ and Zhang YC reviewed the manuscript; All authors approved the final version of the manuscript.
Supported by The Key Science and Technology Program of Zhangjiakou, No. 1921132H.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the First Affiliated Hospital of Hebei North University.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: No conflict of interest for all authors.
Data sharing statement: No additional to be shared.
STROBE statement: The authors have read the STROBE Statement checklist of items, and the manuscript was revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ying-Chun Zhang, MSc, Associate Chief Physician, Associate Professor, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Hebei North University, No. 12 Changqing Road, Qiaoxi District, Zhangjiakou 075061, Hebei Province, China. zhyingchun@sina.cn
Received: December 3, 2020
Peer-review started: December 3, 2020
First decision: December 13, 2020
Revised: December 28, 2020
Accepted: January 15, 2021
Article in press: January 15, 2021
Published online: March 6, 2021
Processing time: 87 Days and 18.1 Hours
ARTICLE HIGHLIGHTS
Research background

Short duration radiation treatment may have a valuable role in the treatment of patients assessed as too frail to undergo long duration chemoradiation. Studies have compared short duration vs long duration radiation treatment for rectal cancer. However, the results are contradictory. The present study explored the efficacy and safety of short duration radiation treatment for advanced rectal cancer.

Research motivation

The present study sought the optimal duration of radiation therapy for advanced rectal cancer to improve survival time and reduce complications and recurrence by comparing short duration vs long duration radiotherapy in patients with advanced rectal cancer.

Research objectives

This study aimed to discuss the efficacy and safety of short duration radiotherapy combined with chemotherapy for the treatment of advanced rectal cancer.

Research methods

This study compared short duration radiation treatment (5 Gy in 5 fractions) with conventional long duration chemoradiation (1.8 to 2.0 Gy in 25 to 28 fractions) in 100 patients with IIIB or IV rectal cancer between December 2018 and December 2019. Expression of Runx3 and Ki-67, chemoradiotherapy-induced adverse reactions, operation indices, 1-yr survival, recurrence and distant metastasis were researched to see whether there was an advantage in the short duration radiation treatment group.

Research results

Almost no statistically significant differences were observed in the incidence and operation indices when comparing short duration radiation treatment with conventional long duration chemoradiation. However, the 1-yr survival rate was higher and the recurrence rate and distant metastasis rate were lower in the short duration radiation group than in the long duration group.

Research conclusions

Based on the results, short duration radiation treatment seems to be effective for the treatment of advanced rectal cancer. In addition, clear survival benefits were observed with low incidence of recurrence and distant metastasis in the short duration radiation group.

Research perspectives

Further studies in a multidisciplinary setting are warranted to identify whether the more convenient short duration radiation treatment should be considered if there are clear concerns regarding a patient’s physical or psychosocial ability to tolerate long duration chemoradiation to determine the most appropriate individualized therapeutic strategy.