title: Role of pelvic radiotherapy for locally advanced rectal cancer and synchronous unresectable distant metastases.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of pelvic irradiation combined systematic chemotherapy in patients with locally advanced (cT3-T4 and/or cN+) rectal cancer and synchronous unresectable distant metastases.
  
  
  METHODS
  A total of 76 eligible patients who received pelvic radiotherapy and concurrent capecitabine-based chemotherapy were retrospectively reviewed. Patients survival curves were constructed using the Kaplan-Meier method, and a multivariate analysis was performed to identify independent prognostic factors.
  
  
  RESULTS
  Most of the adverse events were mild during the period of combined chemoradiotherapy. Twenty-two patients experienced resection of primary tumour and 16 patients underwent radical surgery of all lesions. Only five patients had pelvic progression during the follow-up period. The median progression-free survival and median overall survival were 13 and 30 months, respectively. Radical surgery of all lesions following chemoradiotherapy was found to be an independent prognostic factor according to multivariate analysis.
  
  
  CONCLUSIONS
  Pelvic irradiation combined with systematic chemotherapy in patients with locally advanced rectal cancer and synchronous unresectable distant metastases is effective and tolerable, both for pelvic and distant control. A curative resection following chemoradiotherapy was associated with prolonged survival.
authors: Department of Radiation Oncology, Fudan University Shanghai Cancer Centre, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Department of Radiation Oncology, Lihuili Hospital, Ningbo Medical Centre, 315041 Ningbo, China.
authors: K T
authors: KT
authors: Liu
authors: Department of Radiation Oncology, Fudan University Shanghai Cancer Centre, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors: J F
authors: JF
authors: Wan
authors: Department of Radiation Oncology, Fudan University Shanghai Cancer Centre, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors: J
authors: J
authors: Zhu
authors: Department of Radiation Oncology, Fudan University Shanghai Cancer Centre, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors: G C
authors: GC
authors: Li
authors: Department of Radiation Oncology, Fudan University Shanghai Cancer Centre, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors: W J
authors: WJ
authors: Sun
authors: Department of Radiation Oncology, Fudan University Shanghai Cancer Centre, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors: L J
authors: LJ
authors: Shen
authors: Department of Colorectal Surgery, Fudan University Shanghai Cancer Centre, Shanghai, China.
authors: S J
authors: SJ
authors: Cai
authors: Department of Colorectal Surgery, Fudan University Shanghai Cancer Centre, Shanghai, China.
authors: W L
authors: WL
authors: Gu
authors: Department of Colorectal Surgery, Fudan University Shanghai Cancer Centre, Shanghai, China.
authors: P
authors: P
authors: Lian
authors: Department of Radiation Oncology, Fudan University Shanghai Cancer Centre, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. Electronic address: zhenzhang6@hotmail.com.
authors: Z
authors: Z
authors: Zhang
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery / Q000628:therapy; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000069287:Capecitabine / Q000008:administration & dosage; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000532:radiotherapy / Q000556:secondary; D008175:Lung Neoplasms / Q000532:radiotherapy / Q000556:secondary; D008297:Male; D008875:Middle Aged; D010388:Pelvis; D011379:Prognosis; D016016:Proportional Hazards Models; D012004:Rectal Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery / Q000628:therapy; D012189:Retrospective Studies
chemical_list: D000069287:Capecitabine
keywords: Cancer du rectum; Chemoradiotherapy; Chimioradiothérapie; Curative resection; Metastatic; Métastatique; Non résécable; Pelvic radiotherapy; Radiothérapie pelvienne; Rectal cancer; Résection curative; Unresectable