- 作者：Vincenzo Picardi ; MD&lowast ; ; Francesco Deodato ; MD&lowast ; ; Alessandra Guido ; MD ; PhD&dagger ; ; Lucia Giaccherini ; MD&dagger ; ; Gabriella Macchia ; MD&lowast ; ; gmacchia@rm.unicatt.it" class="auth_mail" title="E-mail the corresponding author ; Leonardo Frazzoni ; MD&Dagger ; ; Andrea Farioli ; MD&Dagger ; ; Dajana Cuicchi ; MD&Dagger ; ; Savino Cilla ; MD&lowast ; ; Francesco Cellini ; MD§ ; ; A.F.M. Kamal Uddin ; MD‖ ; Maria Antonietta Gambacorta ; MD¶ ; ; Milly Buwenge ; PhD&dagger ; ; Andrea Ardizzoni ; MD# ; Gilberto Poggioli ; MD&Dagger ; ; Vincenzo Valentini ; MD¶ ; ; Lorenzo Fuccio ; MD&Dagger ; ; Alessio G. Morganti ; MD&dagger ;
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2016
- 出版时间：15 July 2016
- 年：2016
- 卷：95
- 期：4
- 页码：1184-1190
- 全文大小：364 K
Methods and Materials
Patients who were not candidates for surgical resection because of synchronous metastases, age, and/or comorbidities were considered eligible. The sample size was calculated based on the 2-stage design of Simon. Short-course radiation therapy was delivered with an isocentric 4-field box technique (total, 25 Gy; 5 fractions in 5 days). Chemotherapy was suspended during radiation treatment. Clinical outcome measures were symptomatic response rate, toxicity, colostomy-free survival, and overall survival.
Results
From October 2003 to November 2012, 18 patients (median age, 77.5 years) were enrolled. The median follow-up was 11.5 months (range, 3-36 months). Four weeks after treatment, a complete response (ie, complete symptom resolution) was observed in 38.9% of patients and a partial response in 50.0% cases, whereas 11.1% had no response. The rates of reduction or resolution of pain and bleeding were 87.5% and 100%, respectively. The 1-, 2-, and 3-year colostomy-free survival rates were 100%, 71.4%, and 47.6%, respectively (median, 30 months). The 1-, 2-, and 3-year cumulative overall survival rates were 85.2%, 53%, and 39.8%, respectively (median, 25 months). No patients stopped treatment because of gastrointestinal or genitourinary toxicities: 38.9% of patients had grade 1 to 2 toxicity, and 16.7% had grade 3 toxicity. Only 1 patient had hematologic grade 2 toxicity, and 2 patients had grade 2 skin toxicity.
Conclusions
Short-course radiation therapy may represent a safe and effective alternative treatment option in patients with obstructing rectal cancer not eligible for curative treatment, allowing colostomy to be avoided in a substantial proportion of patients.