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Saeedeh Pourahmad 1 Article
Efficacy and Safety of Low-Dose-Rate Endorectal Brachytherapy as a Boost to Neoadjuvant Chemoradiation in the Treatment of Locally Advanced Distal Rectal Cancer: A Phase-II Clinical Trial
Shapour Omidvari, Shadi Zohourinia, Mansour Ansari, Leila Ghahramani, Mohammad Zare-Bandamiri, Ahmad Mosalaei, Niloofar Ahmadloo, Saeedeh Pourahmad, Hamid Nasrolahi, Sayed Hasan Hamedi, Mohammad Mohammadianpanah
Ann Coloproctol. 2015;31(4):123-130.   Published online August 31, 2015
DOI: https://doi.org/10.3393/ac.2015.31.4.123
  • 4,449 View
  • 34 Download
  • 9 Web of Science
  • 12 Citations
AbstractAbstract PDF
Purpose

Despite advances in rectal cancer treatment over the last decade, local control and risk of late side effects due to external beam radiation therapy (EBRT) remain as concerns. The present study aimed to investigate the efficacy and the safety of low-dose-rate endorectal brachytherapy (LDRBT) as a boost to neoadjuvant chemoradiation for use in treating locally advanced distal rectal adenocarcinomas.

Methods

This phase-II clinical trial included 34 patients (as the study arm) with newly diagnosed, locally advanced (clinical T3-T4 and/or N1/N2, M0) lower rectal cancer. For comparative analysis, 102 matched patients (as the historical control arm) with rectal cancer were also selected. All the patients were treated with LDRBT (15 Gy in 3 fractions) and concurrent chemoradiation (45-50.4 Gy). Concurrent chemotherapy consisted of oxaliplatin 130 mg/m2 intravenously on day 1 plus oral capecitabine 825 mg/m2 twice daily during LDRBT and EBRT.

Results

The study results revealed a significant differences between the study arm and the control arm in terms in the pathologic tumor size (2.1 cm vs. 3.6 cm, P = 0.001), the pathologic tumor stage (35% T3-4 vs. 65% T3-4, P = 0.003), and the pathologic complete response (29.4% vs. 11.7%, P < 0.028). Moreover, a significantly higher dose of EBRT (P = 0.041) was found in the control arm, and a longer time to surgery was observed in the study arm (P < 0.001). The higher rate of treatment-related toxicities, such as mild proctitis and anemia, in the study arm was tolerable and easily manageable.

Conclusion

A boost of LDRBT can optimize the pathologic complete response, with acceptable toxicities, in patients with distal rectal cancer.

Citations

Citations to this article as recorded by  
  • Examining external control arms in oncology: A scoping review of applications to date
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  • Brachytherapy of rectal cancer: comparative characteristics of techniques (review)
    Roman V. Novikov, Sergey N. Novikov
    Koloproktologia.2023; 22(3): 158.     CrossRef
  • Neoadjuvant Radiotherapy Dose Escalation in Locally Advanced Rectal Cancer: a Systematic Review and Meta-analysis of Modern Treatment Approaches and Outcomes
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  • Predictive Significance of Mucinous Histology on Pathologic Complete Response Rate Following Capecitabine-Based Neoadjuvant Chemoradiation in Rectal Cancer: a Comparative Study
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  • A systematic review comparing radiation toxicity after various endorectal techniques
    An-Sofie Verrijssen, Thirza Opbroek, Murillo Bellezzo, Gabriel P. Fonseca, Frank Verhaegen, Jean-Pierre Gerard, Arthur Sun Myint, Evert J. Van Limbergen, Maaike Berbee
    Brachytherapy.2019; 18(1): 71.     CrossRef
  • Is the Pathologic Response of T3 Rectal Cancer to High-Dose-Rate Endorectal Brachytherapy Comparable to External Beam Radiotherapy?
    Richard Garfinkle, Sebastian Lachance, Te Vuong, Alexandre Mikhail, Vincent Pelsser, Adrian Gologan, Nancy A. Morin, Carol-Ann Vasilevsky, Marylise Boutros
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  • Phase 2 Neoadjuvant Treatment Intensification Trials in Rectal Cancer: A Systematic Review
    Mark T.W. Teo, Lucy McParland, Ane L. Appelt, David Sebag-Montefiore
    International Journal of Radiation Oncology*Biology*Physics.2018; 100(1): 146.     CrossRef
  • Colorectal Cancer Staging Using Three Clustering Methods Based on Preoperative Clinical Findings
    Saeedeh Pourahmad, Soudabeh Pourhashemi, Mohammad Mohammadianpanah
    Asian Pacific Journal of Cancer Prevention.2016; 17(2): 823.     CrossRef
  • Lentivirus‐mediated shRNA interference of ghrelin receptor blocks proliferation in the colorectal cancer cells
    An Liu, Chenggang Huang, Jia Xu, Xuehong Cai
    Cancer Medicine.2016; 5(9): 2417.     CrossRef
  • Is Low-Dose-Rate Endorectal Brachytherapy a New Treatment Method for Locally Advanced Distal Rectal Cancer?
    Seung Hyuk Baik
    Annals of Coloproctology.2015; 31(4): 115.     CrossRef
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