Short-term results of neoadjuvant radiation therapy for patients with locally advanced rectal cancer

Backgrounds: Neoadjuvant radiation therapy (NART) followed by total mesorectal excision (TME) is widely accepted for locally advanced rectal cancer (LARC). Patients and methods: This study is retrospectively evaluating the short-term outcomes of NART for patients with LARC. Patients with NART received a long course radiation of 45.0-50.4Gy and daily capecitabine or short course radiation of 25Gy. Sequential chemotherapy with oxaliplatin-based regimen was performed in only the patients who were judged to be unable to undergo R0 resection by imaging. Outcomes: Between June 2017 and January 2021, NART was performed in 38 patients. The clinical stage was cT3/T4 24/14, cN0/N1/N2 5/20/13. 12 patiens had the sequential chemotherapy. The interval between radiotherapy and surgery was 70 days. The surgery was performed by open/Lap/taTME/Robotic 1/17/15/5, and LPLD was performed in 21 cases. The operation time and blood loss were 367.5min and 115.5ml. Grade≥IIIa postoperative complication was occurred in 2 cases. 4 patients achieved pCR, and the median neoadjuvant rectal (NAR) score was 15.0. The patients with pCRM≤1mm was 4 cases. Conclusion: NART for LARC was feasible and safe. Prospective large clinical trials are needed to determine the optimal protocol for neoadjuvant treatment.