Neoadjuvant chemoradiotherapy for patients with unresectable radically locally advanced colon cancer: a potential...

Area of Science:

• Oncology
• Surgical Oncology
• Gastrointestinal Oncology

Background:

• Management of unresectable locally advanced colon cancer (LACC) presents challenges due to non-feasibility of resection.
• Neoadjuvant chemoradiotherapy (NACRT) is being explored as a strategy to improve outcomes in LACC.

Purpose of the Study:

• To evaluate treatment outcomes and toxicity of NACRT followed by surgery and adjuvant chemotherapy in patients with unresectable LACC.
• To assess the feasibility and safety of this multimodal approach.

Main Methods:

• Retrospective analysis of 100 patients diagnosed between 2010-2018.
• NACRT involved radiotherapy combined with capecitabine/5-fluorouracil-based chemotherapy.
• Followed by surgical resection and adjuvant chemotherapy.

Main Results:

• R0 resection rate of 83.0%; 3-year overall survival (OS) of 82.1%.
• Achieved significant downstaging (81.0%) and pathological complete response (pCR) in 18% of patients.
• Common adverse events included grade 3-4 myelosuppression (17%) and surgery-related complications (7.0%).

Conclusions:

• NACRT followed by surgery is a feasible and safe conversion treatment for selected LACC patients.
• This strategy leads to satisfactory tumor downstaging, long-term survival, and quality of life.
• Acceptable toxicity profiles support its use in clinical practice.