Comparison of long term effects between preoperative simultaneous integrated boost intensity-modulated radiation therapy and three dimensional conformal radiotherapy for locally advanced rectal cancer
Objective To compare the long-term effects and later period toxic reactions between preop-erative simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) and 3-dimensional conformal radiotherapy RT (3D-CRT) for locally advanced rectal cancer.Methods A total of 130 patients with clinical stage cT3-4/N+M0 rectal adenocarcinoma receiving neoadjuvant chemoradiotherapy in this hos-pital from May 2010 to May 2015 were selected as the study subjects.The patients were divided into the SIB-IMRT group (66 cases) and 3D-CRT group (64 cases) according to the random number table method.The SIB-IMRT group took the irradiation 55 Gy/25 frequencies,irradiation 45 Gy/25 frequencies in the high risk recurrent region and regional lymphatic drainage area.The 3-DCRT group took the irradiation 45 Gy/25 fre-quencies in the high risk recurrent region and regional lymphatic drainage area.All patients orally took capecitabine (825 mg/m2) on 1-14 d and 22-35 d of radiotherapy (twice daily) in synchronized radiothera-py.The total mesorectal excision was performed in 6-8 weeks after radiotherapy end.The overall survival (OS) rate,disease free survival (DFS) rate,locoregional recurrence free survival (LRFS) rate,distant metas-tasis rate (DMR) and occurrence situation of advanced stage toxic reactions were observed and compared be-tween the two groups.Results The median follow-up time of all study subjects was 105(2,136) months.The 10-year OS rate,DFS rate,LRFS rate and DMR in the SIB-IMRT group was 67.8％,64.5％,91.8％ and 29.9％ respectively,which in the 3D-CRT group was 62.6％,61.2％,88.7％ and 34.5％ respectively,but the differences were not statistically significant (P>0.05).The grade 2 and 3 adverse reactions in the SIB-IMRT group were higher than those in the 3D-CRT group (34.48％ vs. 28.07％),but the difference was not statistically significant (P>0.05).Conclusion SIB-IMRT provides the acceptable long term effect and toxic results than 3D-CRT.
万方数据
维普
