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EVALUATION OF THE EARLY RESULTS OF PREOPERATIVE CONCURRENT CHEMORADIATION THERAPY FOR RECTAL CANCER USING IMRT/VMAT TECHNIQUE AT K HOSPITAL
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Abstract
Objectives: Describing clinical and paraclinical characteristics of rectal cancer patients who received preoperative concurrent chemoradiotherapy and comparing treatment efficacy between IMRT and VMAT techniques at K hospital. Subjects and methods: A retrospective and prospective cross-sectional description study was conducted on 49 patients with low- and mid- RC, the tumor is stage cT3,4 or N(+) who were indicated for preoperative concurrent chemoradiotherapy from March 2022 to July 2024. Results: The mean age was 58.6. The male/female ratio was 1.1/1. The majority of patients were diagnosed within 3 months (57.1%). 63.2% of patients had a mobile tumor on rectal examination. Low- RC accounted for 67.3%, mid- RC accounted for 36.8%. 75.5% of tumors involving more than half of the rectal circumference. Most cases were adenocarcinoma (93.9%). T3 tumors accounted for 65.3%, T4 for 24.5%, and T2 for 10.2%. 57.1% had lymph nodes metastasis. The common features of the IMRT and VMAT groups were similar. After treatment, in IMRT and VMAT groups, , 62.5% and 40.0% had tumors involving less than half of the rectal circumference on endoscopy, respectively; T stages T1, T2, T3, T4 were 12.5%, 62.5%, 16.7%, 8.3% and 4.0%, 60.0%, 28.0%, 12.0%, respectively. Lymph nodes metastasis was present in 41.7% of the IMRT group and 56.0% of the VMAT group. 54.2% patients received IMRT and 48.0% received VMAT technique underwent segmental colectomy. Among low- RC cases, 25.0% and 29.4% had sphincter-preserving surgery corresponding to IMRT and VMAT. The overall sphincter-sparing surgery rate of both group reached 37.5%. Complete and partial pathological responses in the IMRT group were 12.5% and 83.3%, respectively, compared to 12.0% and 76.0% in the VMAT group. The overall response rate on histopathological of IMRT/VMAT techniques was as high as 91.8%. Conclusion: The overall response rate on histopathological of Preoperative concurrent chemoradiotherapy with IMRT/VMAT techniques was 91.8%. Among the total number of patients who underwent surgery in the study, the overall rate of conservative surgery was 37.5%. Subgroup analysis showed that the IMRT/VMAT technique was comparable in terms of local and regional response effectiveness. There was no statistically significant difference in anal sphincter preservation between IMRT and VMAT techniques
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Keywords
rectal cancer, IMRT, VMAT
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