title: Neoadjuvant short-course hyperfractionated accelerated radiotherapy (SC-HART) combined with S-1 for locally advanced rectal cancer.
abstract: The purpose of this study was to examine the safety and feasibility of a novel protocol of neoadjuvant short-course hyperfractionated accelerated radiotherapy (SC-HART) combined with S-1 for locally advanced rectal cancer. A total of 56 patients with lower rectal cancer of cT3N1M0 (Stage III b) was treated with SC-HART followed by radical surgery, and were analyzed in the present study. SC-HART was performed with a dose of 2.5 Gy twice daily, with an interval of at least 6 hours between fractions, up to a total dose of 25 Gy (25 Gy in 10 fractions for 5 days) combined with S-1 for 10 days. Radical surgery was performed within three weeks following the end of the SC-HART. The median age was 64.6 (range, 39-85) years. The median follow-up term was 16.3 (range, 2-53) months. Of the 56 patients, 53 (94.4%) had no apparent adverse events before surgery; 55 (98.2%) completed the full course of neoadjuvant therapy, while one patient stopped chemotherapy because of Grade 3 gastrointestinal toxicity (CTCAE v.3). The sphincter preservation rate was 94.6%. Downstaging was observed in 45 patients (80.4%). Adjuvant chemotherapy was administered to 43 patients (76.8%). The local control rate, disease-free survival rate and disease-specific survival rate were 100%, 91.1% and 100%, respectively. To conclude, SC-HART combined with S-1 for locally advanced rectal cancer was well tolerated and produced good short-term outcomes. SC-HART therefore appeared to have a good feasibility for use in further clinical trials.
authors: Department of Radiology, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya City, Hyogo, 663-8501 Japan.
authors: Hiroshi
authors: H
authors: Doi
authors: Naohito
authors: N
authors: Beppu
authors: Soichi
authors: S
authors: Odawara
authors: Masao
authors: M
authors: Tanooka
authors: Yasuhiro
authors: Y
authors: Takada
authors: Yasue
authors: Y
authors: Niwa
authors: Masayuki
authors: M
authors: Fujiwara
authors: Fumihiko
authors: F
authors: Kimura
authors: Hidenori
authors: H
authors: Yanagi
authors: Naoki
authors: N
authors: Yamanaka
authors: Norihiko
authors: N
authors: Kamikonya
authors: Shozo
authors: S
authors: Hirota
mesh_terms: D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures / Q000401:mortality*; D019583:Dose Fractionation, Radiation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000401:mortality*; D015995:Prevalence; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000401:mortality; D020266:Radiotherapy, Conformal / Q000401:mortality*; D012004:Rectal Neoplasms / Q000401:mortality* / Q000628:therapy*; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
keywords: S-1; accelerated hyperfractionated radiotherapy; preoperative radiotherapy; radiotherapy; rectal cancer; short-course radiotherapy
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