Abstract
Background
The role of adjuvant radiation therapy (RT) in the treatment of resected, locally advanced colon cancer is unclear. One randomized controlled trial (Intergroup-0130) addressed this question but failed to meet its accrual goals. Since this trial, few attempts have been made to reassess the role of RT in this clinical setting.
Methods
Sixty-two patients with non-metastatic, American Joint Committee on Cancer 7th edition stage T4 colonic adenocarcinoma were treated at our institution between 2000 and 2013. All underwent curative-intent surgery. Sixteen patients underwent resection only, 33 patients received adjuvant chemotherapy (ChT), and 13 patients received adjuvant chemoradiation therapy (CRT).
Results
Patients receiving adjuvant CRT were more likely to have T4b (vs. T4a) disease and were more likely to undergo R1 or R2 resection compared with those receiving adjuvant ChT alone. Despite this, multivariate analysis demonstrated that treatment with adjuvant CRT (vs. adjuvant ChT) enhanced locoregional control and disease-free survival (hazard ratio 0.044 and 0.145, respectively; p < 0.05).
Conclusions
Adjuvant RT for T4 colon cancers may be appropriate in select patients, specifically those with T4b lesions and/or residual disease following resection.
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Acknowledgment
The authors thank Dr. Xuefeng Zhang for assistance with pathological review, and Mr. Robert W. Clough for assistance with data acquisition.
Disclosures
Ethan B. Ludmir, Ritu Arya, Yuan Wu, Manisha Palta, Christopher G. Willett, and Brian G. Czito declare no competing interests.
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Ludmir, E.B., Arya, R., Wu, Y. et al. Role of Adjuvant Radiotherapy in Locally Advanced Colonic Carcinoma in the Modern Chemotherapy Era. Ann Surg Oncol 23, 856–862 (2016). https://doi.org/10.1245/s10434-015-4907-3
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DOI: https://doi.org/10.1245/s10434-015-4907-3