Multicentre study of short-course radiotherapy, systemic therapy and resection/ablation for stage IV rectal cancer

E. N. D. Kok; K. Havenga; P. J. Tanis; J. H. W. de Wilt; J. Hagendoorn; F. P. Peters; J. Buijsen; H. J. T. Rutten; K. E. D. Kuhlmann; G. L. Beets; A. G. J. Aalbers; N. F. M. Kok; T. J. M. Ruers; C. B. H. A. Kobus; S. Siemons; C. Grootscholten; L. G. H. Dewit; J. G. van den Berg; null Zavrakidis; K. P. de Jong; G. A. P. Hospers; A. Karrenbeld; E. D. Geijsen; C. J. A. Punt; H. Rutten; S. Radema; M. P. W. Intven; J. M. L. Roodhart; F. Holman; E. Kapiteijn; J. Melenhorst; J. S. Cnossen; G-J M. Creemers; Dutch Stage IV Rectal Cancer Group

doi:10.1002/bjs.11418

Multicentre study of short-course radiotherapy, systemic therapy and resection/ablation for stage IV rectal cancer

E. N. D. Kok^*, K. Havenga, P. J. Tanis, J. H. W. de Wilt, J. Hagendoorn, F. P. Peters, J. Buijsen, H. J. T. Rutten, K. E. D. Kuhlmann, G. L. Beets, A. G. J. Aalbers, N. F. M. Kok, T. J. M. Ruers, C. B. H. A. Kobus, S. Siemons, C. Grootscholten, L. G. H. Dewit, J. G. van den Berg, Zavrakidis, K. P. de JongG. A. P. Hospers, A. Karrenbeld, E. D. Geijsen, C. J. A. Punt, H. Rutten, S. Radema, M. P. W. Intven, J. M. L. Roodhart, F. Holman, E. Kapiteijn, J. Melenhorst, J. S. Cnossen, G-J M. Creemers, Dutch Stage IV Rectal Cancer Group

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background The optimal treatment sequence for patients with rectal cancer and synchronous liver metastases remains unclear. The aim of this study was to evaluate the feasibility and effectiveness of short-course pelvic radiotherapy (5 x 5 Gy) followed by systemic therapy and local treatment of all tumour sites in patients with potentially curable stage IV rectal cancer in daily practice.

Methods This was a retrospective study performed in eight tertiary referral centres in the Netherlands. Patients aged 18 years or above with rectal cancer and potentially resectable liver +/- extrahepatic metastases, treated between 2010 and 2015, were eligible. Main outcomes included full completion of treatment schedule, symptom control and survival.

Results In total, 169 patients were included with a median follow-up of 49 center dot 5 (95 pr cent c.i. 43 center dot 6 to 55 center dot 6) months. The completion rate for the entire treatment schedule was 65 center dot 7 per cent. Three-year progression-free survival and overall survival (OS) rates were 24 center dot 2 (95 per cent c.i. 16 center dot 6 to 31 center dot 6) and 48 center dot 8 (40 center dot 4 to 57 center dot 2) per cent respectively. Median OS of patients who responded well and completed the treatment schedule was 51 center dot 5 months, compared with 15 center dot 1 months for patients who did not complete the treatment (P <0 center dot 001). Adequate symptom control of the primary tumour was achieved in 87 center dot 0 per cent of all patients.

Conclusion Multimodal treatment is palliative in most patients, and associated with good survival rates in those able to complete the schedule.

Original language	English
Pages (from-to)	537-545
Number of pages	9
Journal	British Journal of Surgery
Volume	107
Issue number	5
DOIs	https://doi.org/10.1002/bjs.11418
Publication status	Published - Apr 2020

Keywords

COURSE RADIATION-THERAPY
NEOADJUVANT BEVACIZUMAB
LIVER-1ST APPROACH
COLORECTAL-CANCER
CHEMOTHERAPY
OXALIPLATIN
METASTASES
CAPECITABINE
SURGERY
CHEMORADIOTHERAPY

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Kok, E. N. D., Havenga, K., Tanis, P. J., de Wilt, J. H. W., Hagendoorn, J., Peters, F. P., Buijsen, J., Rutten, H. J. T., Kuhlmann, K. E. D., Beets, G. L., Aalbers, A. G. J., Kok, N. F. M., Ruers, T. J. M., Kobus, C. B. H. A., Siemons, S., Grootscholten, C., Dewit, L. G. H., van den Berg, J. G., Zavrakidis, ... Dutch Stage IV Rectal Cancer Group (2020). Multicentre study of short-course radiotherapy, systemic therapy and resection/ablation for stage IV rectal cancer. British Journal of Surgery, 107(5), 537-545. https://doi.org/10.1002/bjs.11418

@article{d88c00fd6d154fdfa9fd020096bf0755,

title = "Multicentre study of short-course radiotherapy, systemic therapy and resection/ablation for stage IV rectal cancer",

abstract = "Background The optimal treatment sequence for patients with rectal cancer and synchronous liver metastases remains unclear. The aim of this study was to evaluate the feasibility and effectiveness of short-course pelvic radiotherapy (5 x 5 Gy) followed by systemic therapy and local treatment of all tumour sites in patients with potentially curable stage IV rectal cancer in daily practice.Methods This was a retrospective study performed in eight tertiary referral centres in the Netherlands. Patients aged 18 years or above with rectal cancer and potentially resectable liver +/- extrahepatic metastases, treated between 2010 and 2015, were eligible. Main outcomes included full completion of treatment schedule, symptom control and survival.Results In total, 169 patients were included with a median follow-up of 49 center dot 5 (95 pr cent c.i. 43 center dot 6 to 55 center dot 6) months. The completion rate for the entire treatment schedule was 65 center dot 7 per cent. Three-year progression-free survival and overall survival (OS) rates were 24 center dot 2 (95 per cent c.i. 16 center dot 6 to 31 center dot 6) and 48 center dot 8 (40 center dot 4 to 57 center dot 2) per cent respectively. Median OS of patients who responded well and completed the treatment schedule was 51 center dot 5 months, compared with 15 center dot 1 months for patients who did not complete the treatment (P <0 center dot 001). Adequate symptom control of the primary tumour was achieved in 87 center dot 0 per cent of all patients.Conclusion Multimodal treatment is palliative in most patients, and associated with good survival rates in those able to complete the schedule.",

keywords = "COURSE RADIATION-THERAPY, NEOADJUVANT BEVACIZUMAB, LIVER-1ST APPROACH, COLORECTAL-CANCER, CHEMOTHERAPY, OXALIPLATIN, METASTASES, CAPECITABINE, SURGERY, CHEMORADIOTHERAPY",

author = "Kok, {E. N. D.} and K. Havenga and Tanis, {P. J.} and {de Wilt}, {J. H. W.} and J. Hagendoorn and Peters, {F. P.} and J. Buijsen and Rutten, {H. J. T.} and Kuhlmann, {K. E. D.} and Beets, {G. L.} and Aalbers, {A. G. J.} and Kok, {N. F. M.} and Ruers, {T. J. M.} and Kobus, {C. B. H. A.} and S. Siemons and C. Grootscholten and Dewit, {L. G. H.} and {van den Berg}, {J. G.} and Zavrakidis and {de Jong}, {K. P.} and Hospers, {G. A. P.} and A. Karrenbeld and Geijsen, {E. D.} and Punt, {C. J. A.} and H. Rutten and S. Radema and Intven, {M. P. W.} and Roodhart, {J. M. L.} and F. Holman and E. Kapiteijn and J. Melenhorst and Cnossen, {J. S.} and Creemers, {G-J M.} and {Dutch Stage IV Rectal Cancer Group}",

note = "Publisher Copyright: {\textcopyright} 2020 BJS Society Ltd Published by John Wiley & Sons Ltd",

year = "2020",

month = apr,

doi = "10.1002/bjs.11418",

language = "English",

volume = "107",

pages = "537--545",

journal = "British Journal of Surgery",

issn = "0007-1323",

publisher = "Wiley",

number = "5",

}

Kok, END, Havenga, K, Tanis, PJ, de Wilt, JHW, Hagendoorn, J, Peters, FP, Buijsen, J , Rutten, HJT, Kuhlmann, KED, Beets, GL, Aalbers, AGJ, Kok, NFM, Ruers, TJM, Kobus, CBHA, Siemons, S, Grootscholten, C, Dewit, LGH, van den Berg, JG, Zavrakidis, de Jong, KP, Hospers, GAP, Karrenbeld, A, Geijsen, ED, Punt, CJA, Rutten, H, Radema, S, Intven, MPW, Roodhart, JML, Holman, F, Kapiteijn, E, Melenhorst, J, Cnossen, JS, Creemers, G-JM & Dutch Stage IV Rectal Cancer Group 2020, 'Multicentre study of short-course radiotherapy, systemic therapy and resection/ablation for stage IV rectal cancer', British Journal of Surgery, vol. 107, no. 5, pp. 537-545. https://doi.org/10.1002/bjs.11418

TY - JOUR

T1 - Multicentre study of short-course radiotherapy, systemic therapy and resection/ablation for stage IV rectal cancer

AU - Kok, E. N. D.

AU - Havenga, K.

AU - Tanis, P. J.

AU - de Wilt, J. H. W.

AU - Hagendoorn, J.

AU - Peters, F. P.

AU - Buijsen, J.

AU - Rutten, H. J. T.

AU - Kuhlmann, K. E. D.

AU - Beets, G. L.

AU - Aalbers, A. G. J.

AU - Kok, N. F. M.

AU - Ruers, T. J. M.

AU - Kobus, C. B. H. A.

AU - Siemons, S.

AU - Grootscholten, C.

AU - Dewit, L. G. H.

AU - van den Berg, J. G.

AU - Zavrakidis, null

AU - de Jong, K. P.

AU - Hospers, G. A. P.

AU - Karrenbeld, A.

AU - Geijsen, E. D.

AU - Punt, C. J. A.

AU - Rutten, H.

AU - Radema, S.

AU - Intven, M. P. W.

AU - Roodhart, J. M. L.

AU - Holman, F.

AU - Kapiteijn, E.

AU - Melenhorst, J.

AU - Cnossen, J. S.

AU - Creemers, G-J M.

AU - Dutch Stage IV Rectal Cancer Group

PY - 2020/4

Y1 - 2020/4

N2 - Background The optimal treatment sequence for patients with rectal cancer and synchronous liver metastases remains unclear. The aim of this study was to evaluate the feasibility and effectiveness of short-course pelvic radiotherapy (5 x 5 Gy) followed by systemic therapy and local treatment of all tumour sites in patients with potentially curable stage IV rectal cancer in daily practice.Methods This was a retrospective study performed in eight tertiary referral centres in the Netherlands. Patients aged 18 years or above with rectal cancer and potentially resectable liver +/- extrahepatic metastases, treated between 2010 and 2015, were eligible. Main outcomes included full completion of treatment schedule, symptom control and survival.Results In total, 169 patients were included with a median follow-up of 49 center dot 5 (95 pr cent c.i. 43 center dot 6 to 55 center dot 6) months. The completion rate for the entire treatment schedule was 65 center dot 7 per cent. Three-year progression-free survival and overall survival (OS) rates were 24 center dot 2 (95 per cent c.i. 16 center dot 6 to 31 center dot 6) and 48 center dot 8 (40 center dot 4 to 57 center dot 2) per cent respectively. Median OS of patients who responded well and completed the treatment schedule was 51 center dot 5 months, compared with 15 center dot 1 months for patients who did not complete the treatment (P <0 center dot 001). Adequate symptom control of the primary tumour was achieved in 87 center dot 0 per cent of all patients.Conclusion Multimodal treatment is palliative in most patients, and associated with good survival rates in those able to complete the schedule.

AB - Background The optimal treatment sequence for patients with rectal cancer and synchronous liver metastases remains unclear. The aim of this study was to evaluate the feasibility and effectiveness of short-course pelvic radiotherapy (5 x 5 Gy) followed by systemic therapy and local treatment of all tumour sites in patients with potentially curable stage IV rectal cancer in daily practice.Methods This was a retrospective study performed in eight tertiary referral centres in the Netherlands. Patients aged 18 years or above with rectal cancer and potentially resectable liver +/- extrahepatic metastases, treated between 2010 and 2015, were eligible. Main outcomes included full completion of treatment schedule, symptom control and survival.Results In total, 169 patients were included with a median follow-up of 49 center dot 5 (95 pr cent c.i. 43 center dot 6 to 55 center dot 6) months. The completion rate for the entire treatment schedule was 65 center dot 7 per cent. Three-year progression-free survival and overall survival (OS) rates were 24 center dot 2 (95 per cent c.i. 16 center dot 6 to 31 center dot 6) and 48 center dot 8 (40 center dot 4 to 57 center dot 2) per cent respectively. Median OS of patients who responded well and completed the treatment schedule was 51 center dot 5 months, compared with 15 center dot 1 months for patients who did not complete the treatment (P <0 center dot 001). Adequate symptom control of the primary tumour was achieved in 87 center dot 0 per cent of all patients.Conclusion Multimodal treatment is palliative in most patients, and associated with good survival rates in those able to complete the schedule.

KW - COURSE RADIATION-THERAPY

KW - NEOADJUVANT BEVACIZUMAB

KW - LIVER-1ST APPROACH

KW - COLORECTAL-CANCER

KW - CHEMOTHERAPY

KW - OXALIPLATIN

KW - METASTASES

KW - CAPECITABINE

KW - SURGERY

KW - CHEMORADIOTHERAPY

U2 - 10.1002/bjs.11418

DO - 10.1002/bjs.11418

M3 - Article

C2 - 32017049

SN - 0007-1323

VL - 107

SP - 537

EP - 545

JO - British Journal of Surgery

JF - British Journal of Surgery

IS - 5

ER -