The comparison of late complications between 2D conventional radiotherapy and 3D conformal radiotherapy with adjuvant chemotherapy for patients with rectal cancer in Siriraj Hospital
Keywords:
rectal cancer, 2D radiotherapy, 3D conformal radiotherapy, late complicationAbstract
Background: The transition of adjuvant radiotherapy techniques in treating locally advanced rectal cancer had been developed from 2-dimension conventional radiotherapy (2D-RT) to 3-dimensional conformal radiotherapy (3D-CRT). Theoretically, the 3D-CRT technique showed the advantage of more target dose coverage in treating field and lessen normal tissue toxicity compared to 2D-RT technique.
Objectives: To compare late radiation complications and quality of life (QoL) between patients receiving 2D-RT and 3D-CRT.
Materials and Methods: Locally advanced rectal cancer patients (T2-4 and/or lymph node positive), who received adjuvant either pre- or post-operative concurrent chemoradiotherapy between January 2012 and December 2018, were divided into 2 treatment groups: 2D-RT or 3D-CRT. After long term follow-up, we evaluated the late radiation complications using the RTOG/EORTC Late Radiation Morbidity Scoring Schema, and the QoL using the FACT-C Questionnaires, version 4.
Results: 235 locally advanced rectal cancer patients, (2D-RT; n = 62 and 3D-CRT; n = 173), were enrolled in this study. The median follow-up time was 4.92 years in 2D-RT group vs. 2.18 years in 3D-CRT group. There was no significant difference in late small / large intestine and bladder complications between 2 treatment groups. However, the QoL measurement showed better scores in longer follow-up time.
Conclusion: The longer follow-up periods had a significant impact on greater daily living. While there was no difference in late small / large intestine and bladder complications between both radiation techniques.
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