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Date Published:
02/02/2026
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Vũ, N. S., Triệu, T. D., & Phạm, V. T. (2026). CLINICAL AND PARACLINICAL CHARACTERISTICS AND EVALUATE THE EFFECTIVENESS OF LONG-COURSE NEOADJUVANT CHEMORADIOTHERAPY IN PATIENTS WITH MID - AND LOW-RECTAL ADENOCARCINOMA. Vietnam Medical Journal, 558(2). https://doi.org/10.51298/vmj.v558i2.17083
CLINICAL AND PARACLINICAL CHARACTERISTICS AND EVALUATE THE EFFECTIVENESS OF LONG-COURSE NEOADJUVANT CHEMORADIOTHERAPY IN PATIENTS WITH MID - AND LOW-RECTAL ADENOCARCINOMA
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Abstract
Objective: To describe clinical and paraclinical characteristics and evaluate the effectiveness of long-course neoadjuvant chemoradiotherapy (LCCRT) in patients with mid- and low-rectal adenocarcinoma. Methods: A retrospective–prospective study was conducted on 168 stage II–III rectal cancer patients treated with LCCRT followed by laparoscopic radical surgery at Military Central Hospital 108 (August 2018 – August 2023). Results: Mean age was 62.0 ± 10.9 years; males accounted for 69.6%. Tumor location: mid-rectum 50.6%, low rectum 49.4%. MRI before treatment showed 71.4% cT3, and 95.24% were stage III. After LCCRT, 98.8% completed the regimen; 41.1% had complete symptom relief. Post-treatment MRI demonstrated 46.43% with moderate response (mrTRG 3) and 14.88% with complete response. Pathology confirmed a complete tumor regression rate of 22.02%. There was a significant stage distribution shift (p = 0.000), with stage III reduced to 14.3% and 18.5% achieving complete response (stage 0). Conclusion: LCCRT prior to surgery significantly improved tumor regression and downstaging, while ensuring safety and high treatment compliance.
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Keywords
Rectal cancer; Long-course chemoradiotherapy; Laparoscopy.
References
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2. Glynne J.R., Wyrwicz L., Tiret E., et al. (2017). ESMO Guidelines Committee. Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 28, 22-40.
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.
4. Huỳnh Thanh Tuệ, Phạm Nguyên Tường, Hoàng Nguyễn Hoài An, Nguyễn Minh Hành (2022). Đánh giá kết quả hóa xạ trị tiền phẫu ung thư trực tràng tại Bệnh viện Trung ương Huế. Tạp chí Y học lâm sàng Bệnh viện Trung Ương Huế. 82.
5. Park C.H., Kim H.C., Cho Y.B., et al (2011). Predicting tumor response after preoperative chemoradiation using clinical parameters in rectal cancer. World J Gastroenterol. 17(48), 5310-6.
6. 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.
7. MERCURY Study Group (2011). Prognostic significance of tumor regression grade as assessed by MRI (mrTRG) in rectal cancer. Ann Oncol. 22(9), 1827–1834.
8. Bujko K., et al. (2010). Tumour regression grading in patients with residual rectal cancer after preoperative chemoradiation. Radiotherapy and Oncology. 95(3), 298 - 302.
9. 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.