title: Neoadjuvant oral vs. infusional chemoradiotherapy on locally advanced rectal cancer: Prognostic factors.
abstract: OBJECTIVE
  To evaluate the prognostic factors and impact on survival of neoadjuvant oral and infusional chemoradiotherapy in patients with locally advanced rectal cancer.
  
  
  BACKGROUND
  There is still no definitive consensus about the prognostic factors and the impact of neoadjuvant chemoradiotherapy on survival. Some studies have pointed to an improvement in overall survival (OS) and progression-free survival (PFS) in patients with tumor downstaging (TD) and nodal downstaging (ND).
  
  
  METHODS
  A set of 159 patients with LARC were treated preoperatively. Group A - 112 patients underwent concomitant oral chemoradiotherapy: capecitabine or UFT + folinic acid. Group B - 47 patients submitted to concomitant chemoradiation with 5-FU in continuous infusion. 63.6% of patients were submitted to adjuvant chemotherapy.
  
  
  RESULTS
  
  pathologic complete response (pCR) - 18.7%; TD - 55.1%; ND - 76%; loco-regional response - 74.8%. Group B: pCR - 11.4%; TD - 50%; ND - 55.8%; LRR - 54.5%. The loco-regional control was 95.6%. There was no difference in survival between both groups. Those with loco-regional response had better PFS.
  
  
  CONCLUSIONS
  Tumor and nodal downstaging, loco-regional response and a normal CEA level turned out to be important prognostic factors in locally advanced rectal cancer. Nodal downstaging and loco-regional response were higher in Group A. Those with tumor downstaging and loco-regional response from Group A had better OS. Adjuvant chemotherapy had no impact on survival except in those patients with loco-regional response who achieved a higher PFS.
authors.affiliation: Radiotherapy Department, Hospitais da Universidade de Coimbra, Portugal.
authors.forename: Sofia
authors.initials: S
authors.lastname: Conde
authors.affiliation: Radiotherapy Department, Hospitais da Universidade de Coimbra, Portugal.
authors.forename: Margarida
authors.initials: M
authors.lastname: Borrego
authors.affiliation: Radiotherapy Department, Hospitais da Universidade de Coimbra, Portugal.
authors.forename: Tânia
authors.initials: T
authors.lastname: Teixeira
authors.affiliation: Radiotherapy Department, Hospitais da Universidade de Coimbra, Portugal.
authors.forename: Rubina
authors.initials: R
authors.lastname: Teixeira
authors.affiliation: Oncology Department, Hospitais da Universidade de Coimbra, Portugal.
authors.forename: Anabela
authors.initials: A
authors.lastname: Sá
authors.affiliation: Radiotherapy Department, Hospitais da Universidade de Coimbra, Portugal.
authors.forename: Paula
authors.initials: P
authors.lastname: Soares
keywords: Adjuvant chemotherapy; Neoadjuvant infusional chemoradiotherapy; Neoadjuvant oral chemoradiotherapy; Prognostic factors; Rectal cancer