Neoadjuvant radiotherapy improves overall survival for T3/4N+M0 rectal cancer patients: a population-based study of 20300 patients

• Published in: Radiation oncology (London, England) England), 2020-02, Vol.15 (1), p.49-11, Article 49
• Main Authors: Zhao, Feng, Wang, Jili, Yu, Hao, Cheng, Xiaofei, Li, Xinke, Zhu, Xuan, Xu, Xiangming, Lin, Jianjiang, Chen, Xin, Yan, Senxiang
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; African Continental Ancestry Group; Age; Age Factors; Aged; Aged, 80 and over; Cancer patients; Cancer research; Cancer therapies; Cancer treatment; Care and treatment; Chemotherapy; Colorectal cancer; Development and progression; Epidemiology; Female; Health risk assessment; Humans; Intelligence gathering; Male; Marital status; Medical research; Methods; Middle Aged; Neoplasm Staging; Overall survival (OS); Patient outcomes; Patients; Population; Population studies; Population-based studies; Prognosis; Proportional Hazards Models; Radiation; Radiation therapy; Radiotherapy; Radiotherapy (RT); Radiotherapy, Adjuvant; Rectal cancer; Rectal Neoplasms - mortality; Rectal Neoplasms - pathology; Rectal Neoplasms - radiotherapy; Rectum; Regression analysis; Retirement benefits; Studies; Surgery; Therapeutics; Tumors; Young Adult
• ISSN: 1748-717X; 1748-717X
• DOI: 10.1186/s13014-020-01497-4

Neoadjuvant radiotherapy (RT) has been shown to improve local control; however, whether it can improve overall survival (OS) in locally advanced rectal cancer (LARC) patients remains controversial. We therefore aimed to examine the benefits of surgery alone, neoadjuvant radiotherapy (RT), adjuvant RT, and surgery plus chemotherapy in stage II (T3/4N0M0) and III (any T and N + M0) on the OS of rectal cancer patients. Date from the Surveillance, Epidemiology, and End Results (SEER) database diagnosed between 2004 and 2016 were used. Kaplan-Meier analyses were used to compare patient prognoses across different treatment modalities. Cox hazard regression analysis were used to identify independent predictors of OS. For stage T3/4N0M0 patients, neoadjuvant RT, adjuvant RT, and surgery plus chemotherapy resulted in similar OS (all p > 0.05; mean survival, 115.89 months (M), 111.97 M, and 117.22 M, respectively), with better OS observed in these patients than in patients who underwent surgery alone (all p  0.05; mean survival, 121.50 M, 124.25 M, and 121.20 M, respectively), with better OS observed in these patients than in patients who underwent surgery alone (all p