Dr Sun and colleagues examined the overall survival differences for the following neoadjuvant therapy modalities – no therapy, chemotherapy alone, radiation alone and chemoradiation – in a large cohort of patients with locally advanced rectal cancer.
Adults with clinical Stage II and III rectal adenocarcinoma were selected from the National Cancer Database and grouped by type of neoadjuvant therapy received.
The groups included no therapy, chemotherapy only, radiotherapy only or chemoradiation.
Among 32,978 patients included, the researchers noted that 30% received no neoadjuvant therapy, 3% had chemotherapy only, 4% had radiotherapy only, and 64% had chemoradiation.
|64% had chemoradiation|
Compared with no therapy, the team found that chemotherapy or radiotherapy alone were not associated with any adjusted differences in surgical margin positivity, permanent colostomy rate or overall survival, decreased rate of permanent and overall survival.
When compared with chemotherapy or radiotherapy alone, chemoradiation remained associated with improved overall survival.
Dr Sun's team concludes, "Neoadjuvant chemoradiation, not chemotherapy or radiotherapy alone, is important for sphincter preservation, R0 resection and survival for patients with locally advanced rectal cancer."
"Despite this finding, one-third of patients in the United States with locally advanced rectal cancer fail to receive stage-appropriate chemoradiation."