Multimodal treatment improves symptoms, survival in stage IV rectal cancer

Multimodal treatment with short-course radiotherapy, systemic therapy, and resection or ablation in stage IV rectal cancer patients results in symptoms relief and is associated with good survival rates among those who are able to complete the schedule, a recent study has shown.

The authors assessed 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.

This retrospective study was conducted in eight tertiary referral centres in the Netherlands and enrolled patients aged ≥18 years with rectal cancer and potentially resectable liver ± extrahepatic metastases, treated between 2010 and 2015. Full completion of treatment schedule, symptom control and survival were the main outcomes.

Overall, 169 patients were eligible for analysis, with a median follow-up of 49.5 months (95 percent confidence interval [CI], 43.6–55.6). The completion rate was 65.7 percent for the entire treatment schedule.

Three-year progression-free survival rate was 24.2 percent (95 percent CI, 16.6–31.6), while overall survival (OS) rate was 48.8 percent (95 percent CI, 40.4–57.2). Patients who responded well and completed the treatment schedule had greater median OS than those who did not complete the treatment (51.5 vs 15.1 months; p<0.001).

In addition, 87.0 percent of all patients achieved adequate symptom control of the primary tumour.