Articles Vol. 67 No. CĐ7-Trường ĐH Y Dược Hải Phòng 06/07/2026

EVALUATE THE EFFICACY OF LONG-COURSE NEOADJUVANT CHEMORADIOTHERAPY IN PATIENTS WITH STAGE II–III LOW RECTAL CANCER TREATED AT 108 MILITARY CENTRAL HOSPITAL.

Pham Van Thuong1,2, Trieu Trieu Duong3,4, Vu Ngoc Son5,6
1 Hai Phong University of Medicine and Pharmacy
2 Đại học Y Dược Hải Phòng
3 Tam Anh Hospital
4 Bệnh viện Tâm Anh Hà Nội
5 108 Military Central Hospital
6 Bệnh viện Trung ương Quân đội 108
DOI: 10.52163/yhc.v67iCD7.5614
19 Views
0 Downloads
Abstract

Objective: To evaluate the efficacy of long-course neoadjuvant chemoradiotherapy in patients with stage II–III low rectal cancer treated at 108 Military Central Hospital.

Subjects and methods: A retrospective descriptive study was conducted on 83 patients with stage II–III low rectal cancer who received long-course neoadjuvant chemoradiotherapy at 108 Military Central Hospital from August 2018 to August 2023.

Results: Tumor size decreased from 5.17 ± 1.90 cm to 3.96 ± 1.94 cm (p < 0.001). The proportion of tumors staged as T3–4 on MRI decreased from 95.2% to 62.7%. The rate of regional lymph node positivity on MRI decreased from 94.0% to 67.5% (p < 0.001). The proportion of patients with CEA > 5 ng/mL decreased from 48.2% to 10.8%. Overall, 97.6% of patients completed the chemoradiotherapy regimen as planned. On post-treatment MRI, mrTRG 1–3 accounted for 77.1%. The rates of pathological response were 22.9% for complete response (TRG 1), 16.9% for TRG 2, 43.4% for TRG 3, 12.0% for TRG 4, and 4.8% for TRG 5.

Conclusion: Long-course preoperative chemoradiotherapy in patients with lower-third rectal cancer is a safe and effective treatment modality. It contributes to tumor downsizing, downstaging of mural invasion, reduction in MRI-detected lymph node involvement, decreased CEA levels, and a high rate of favorable histopathological response.

References
[1]
Sauer R., Liersch T., Merkel S., et al (2012). Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years. J Clin Oncol. 30, 1926-1933. Google Scholar
[2]
Sauer R., Becker H., Hohenberger W., et al. (2004). Preoperative versus Postoperative Chemoradiotherapy for Rectal Cancer. N Engl J Med. 351, 1731-1740. Google Scholar
[3]
Patel U.B., Taylor F., Blomqvist L., et al (2011). Magnetic resonance imaging-detected tumor response for locally advanced rectal cancer predicts survival outcomes: MERCURY experience. J Clin Oncol. 29(28), 3753-60. Google Scholar
[4]
Mandard A.M., Dalibard F., Mandard J.C., et al (1994). Pathologic assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma. Clinicopathologic correlations. Cancer. 73(11), 2680-6. Google Scholar
[5]
Benson A.B., Venook A.P., Adam M., et al (2024). NCCN Guidelines Insights: Rectal Cancer, Version 3.2024. J Natl Compr Canc Netw. 22(6), 366-375. Google Scholar
[6]
Hofheinz R.D., Fokas E., Benhaim L., et al (2025). Localised rectal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 36(9), 1007-1024. Google Scholar
[7]
Joo J.I., Lim S.W., Oh B.Y. (2021). Prognostic Impact of Carcinoembryonic Antigen Levels in Rectal Cancer Patients Who Had Received Neoadjuvant Chemoradiotherapy. Ann Coloproctol. 37(3), 179-185. Google Scholar
[8]
Bahadoer R.R., Dijkstra E.A., van Etten B., et al (2021). Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial. Lancet Oncol. 22(1), 29-42. Google Scholar
[9]
Santos M.D., Silva C., Rocha A., et al (2013). Tumor regression grades: can they influence rectal cancer therapy decision tree? Int J Surg Oncol. Google Scholar
[10]
Song C., Chung J.H., Kang S.B. (2018). Impact of Tumor Regression Grade as a Major Prognostic Factor in Locally Advanced Rectal Cancer after Neoadjuvant Chemoradiotherapy: A Proposal for a Modified Staging System. Cancers (Basel). 10(9), 319. Google Scholar