Concurrent chemoradiotherapy acceptable for LACC

Concurrent chemoradiotherapy yields acceptable long-term oncologic outcomes with a tolerable safety profile in patients with locally advanced colon cancer (LACC), a recent study has found.

Researchers retrospectively reviewed real-world data of 75 LACC patients (median age 65 years, 60 percent men) who had received neoadjuvant concurrent chemoradiotherapy with folinic acid, 5-fluorouracil, and oxaliplatin. Outcomes included toxicities and long-term oncologic outcomes.

Seventy-two tumours were resected and underwent histopathological examination. Of these, 13 showed no visible cancer cells at the primary site and were deemed to have complete response. In contrast, 39 samples had serosa invasion and nine specimens showed tumour invasion outside the colon.

In terms of toxicity, the researchers found that concurrent chemoradiotherapy frequently triggered haematologic adverse events (AE), with 80.0 percent (n=60) and 82.7 percent (n=62) of participants developing leukopaenia and anaemia, respectively. Nonhaematologic AEs commonly included fatigue and nausea. Most AEs were mild or moderate in severity.

Over a median follow-up of 41.8 months, the 5-year overall survival rate (OS) was estimated to be 68.8 percent, with a median period of 72.3 months. Meanwhile, estimated 5-year disease-free survival rate was 50.6 percent over a median period of 58.7 months.

The researchers then performed multivariate logistic to identify factors affecting OS and found that pathologic N downstaging was strongly and independently associated with better OS (odds ratio [OR], 4.125, 95 percent confidence interval [CI], 1.266–13.436; p=0.019). On the other hand, local recurrence (OR, 0.111, 95 percent CI, 0.03–0.403; p=0.001) and diabetes mellitus (OR, 0.150, 95 percent CI, 0.05–0.447; p=0.001) were predictive of worse OS.