The comparative long term survival analysis of 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, overall survival rate, disease-free survival, locoregional recurrence rate, distant metastasis rateAbstract
Background: Rectal cancer is the third most common cancer in the world. The adjuvant concurrent chemoradiotherapy (CCRT) has been used as a curative treatment. The standard radiation technique was shifted from 2-dimension conventional radiotherapy (2D-RT) to 3-dimension conformal radiotherapy (3D-CRT) for additional benefits during 2015-2018.
Objective: The primary endpoints of this study were the overall survival rate (OS) and the disease-free survival rate (DFS). The secondary endpoints were locoregional recurrence rate (LRR) and distant metastasis rate (DM).
Materials and Methods: Between January 2012 and December 2018, the locally advanced rectal cancer patients (T2-4 and/or lymph node positive) who had received either pre- or post-operative adjuvant CCRT were divided into two treatment technique groups: 2D-RT or 3D-CRT.
Results: One hundred and ninety-two locally advanced rectal cancer patients, (2D-RT; n = 49 and 3D-CRT; n = 143), were enrolled in this study. The median follow-up time was 5.4 years. There was no significant difference in 5-year OS (89.8% in 2D-RT vs. 87.4% in 3D-CRT, p-value= 0.297) and 5-year DFS (87.8% in 2D-RT vs. 79.0% in 3D-CRT, p-value=0.352). The overall 5-years LRR and DM were 4.2% and 16.7%, respectively.
Conclusion: For locally advanced rectal cancer, there was no difference in OS and DFS in patients who underwent either adjuvant 2D-RT or 3D-CRT.
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