• Int. J. Radiat. Oncol. Biol. Phys. · Feb 2012

    Tumor volume reduction rate after preoperative chemoradiotherapy as a prognostic factor in locally advanced rectal cancer.

    • Seung-Gu Yeo, Dae Yong Kim, Ji Won Park, Jae Hwan Oh, Sun Young Kim, Hee Jin Chang, Tae Hyun Kim, Byung Chang Kim, Dae Kyung Sohn, and Min Ju Kim.
    • Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
    • Int. J. Radiat. Oncol. Biol. Phys. 2012 Feb 1; 82 (2): e193-9.

    PurposeTo investigate the prognostic significance of tumor volume reduction rate (TVRR) after preoperative chemoradiotherapy (CRT) in locally advanced rectal cancer (LARC).Methods And MaterialsIn total, 430 primary LARC (cT3-4) patients who were treated with preoperative CRT and curative radical surgery between May 2002 and March 2008 were analyzed retrospectively. Pre- and post-CRT tumor volumes were measured using three-dimensional region-of-interest MR volumetry. Tumor volume reduction rate was determined using the equation TVRR (%) = (pre-CRT tumor volume--post-CRT tumor volume) × 100/pre-CRT tumor volume. The median follow-up period was 64 months (range, 27-99 months) for survivors. Endpoints were disease-free survival (DFS) and overall survival (OS).ResultsThe median TVRR was 70.2% (mean, 64.7% ± 22.6%; range, 0-100%). Downstaging (ypT0-2N0M0) occurred in 183 patients (42.6%). The 5-year DFS and OS rates were 77.7% and 86.3%, respectively. In the analysis that included pre-CRT and post-CRT tumor volumes and TVRR as continuous variables, only TVRR was an independent prognostic factor. Tumor volume reduction rate was categorized according to a cutoff value of 45% and included with clinicopathologic factors in the multivariate analysis; ypN status, circumferential resection margin, and TVRR were significant prognostic factors for both DFS and OS.ConclusionsTumor volume reduction rate was a significant prognostic factor in LARC patients receiving preoperative CRT. Tumor volume reduction rate data may be useful for tailoring surgery and postoperative adjuvant therapy after preoperative CRT.Copyright © 2012 Elsevier Inc. All rights reserved.

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