Short-Term Outcomes and Cost-Effectiveness between Long-Course Chemoradiation and Short-Course Radiotherapy for...

Area of Science:

• Oncology
• Surgical Oncology
• Radiotherapy

Background:

• Long-course chemoradiotherapy (LCRT) is standard for rectal cancer.
• Emerging data suggests short-course radiotherapy (SCRT) may offer benefits.

Purpose of the Study:

• Compare short-term outcomes of SCRT versus LCRT in high-risk rectal cancer patients.
• Analyze the cost-effectiveness of SCRT versus LCRT under the Korean medical insurance system.

Main Methods:

• Retrospective study of 62 high-risk rectal cancer patients.
• Two groups: SCRT (n=27) and LCRT (n=35), both followed by total mesorectal excision (TME).
• XELOX chemotherapy regimen used in the SCRT group; capecitabine-based regimen in the LCRT group.

Main Results:

• Pathological complete response rates were 18.5% for SCRT and 5.7% for LCRT (p=0.223).
• 2-year recurrence-free survival rates were similar (91.9% vs. 76.2%, p=0.394).
• SCRT demonstrated significant cost reductions: 18% lower for inpatient and 40% lower for outpatient treatment.

Conclusions:

• SCRT is well-tolerated and yields favorable short-term outcomes in rectal cancer.
• SCRT offers significant cost savings and demonstrates superior cost-effectiveness compared to LCRT.
• SCRT emerges as a dominant treatment strategy for high-risk rectal cancer.