Analysis of Patients With Locally Advanced Rectal Cancer Given Neoadjuvant Radiochemotherapy With or Without Rt Dose Intensification: A Multicenter Retrospective Study

Analysis of Patients With Locally Advanced Rectal Cancer Given Neoadjuvant Radiochemotherapy With or Without Rt Dose Intensification: A Multicenter Retrospective Study – Atlantis Part I Publisher Pubmed

Nicosia L¹ ; Bonu ML² ; Angelicone I³ ; Lunardi G⁴ ; Niespolo RM⁵ ; Zannetti M⁶ ; Agolli L⁷ ; Chiloiro G⁸ ; Romano A⁸ ; Jafari F^{9, 10} ; Aghili M^{9, 10} ; Ghalehtaki R^{9, 10} ; Montesi G¹¹ ; De Felice F¹² Show All Authors

Nicosia L¹
Bonu ML²
Angelicone I³
Lunardi G⁴
Niespolo RM⁵
Zannetti M⁶
Agolli L⁷
Chiloiro G⁸
Romano A⁸
Jafari F^{9, 10}
Aghili M^{9, 10}
Ghalehtaki R^{9, 10}
Montesi G¹¹
De Felice F¹²
De Renzi F¹³
Magli A¹³
Le Guevelou J¹⁴
Lupattelli M¹⁵
Minniti G¹²
Gambacorta MA⁸
Habermehl D⁷
Franco P⁶
Arcangeli S⁵
Buglione M²
Alongi F^{1, 16}
Osti MF³

Show Affiliations

1. Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Negrar di Valpolicella, Italy
2. Radiation Oncology Department, ASST Spedali Civili di Brescia - Brescia University, Brescia, Italy
3. Department of Radiation Oncology, “Sapienza” University, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, Rome, 00189, Italy
4. Clinical Analysis Laboratory and Transfusional Medicine, Clinical Pharmacology, IRCCS-Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
5. Radiation Oncology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
6. Division of Radiation Oncology, Department of Translational Medicine, University of Eastern Piedmont, University Hospital “Maggiore della Carita”, Novara, Italy
7. Department of Radiation Oncology, Justus-Liebig-University Giessen, Giessen-Marburg University Hospital, Giessen, Germany
8. UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
9. Department of Radiation Oncology, Cancer Institute, Imam-Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
10. Radiation Oncology Research Center (RORC), Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
11. Radiotherapy Unit ULSS5, Rovigo, Italy
12. Radiation Oncology, Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
13. Radiotherapy Unit, San Martino Hospital, Belluno, Italy
14. Department of Radiation Therapy, Centre Eugene Marquis, Rennes, France
15. Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia and Perugia General Hospital, Perugia, 06129, Italy
16. University of Brescia, Brescia, Italy

Source: Radiotherapy and Oncology Published:2025

Abstract

Introduction: Preoperative radiochemotherapy (RCHT) is the standard of care for locally advanced rectal cancer (LARC). While there are several data regarding chemotherapy intensification, actually, no reliable data directly comparing different radiotherapy (RT) dose levels are available. The present study aimed to compare intensified RT versus standard dose in patients with LARC. Materials and methods: Data from 12 centers were collected for the current large retrospective study. The primary end-point evaluated whether RT dose intensification was associated with an increased pathological complete response (pCR). The secondary end-points explored the relation between RT dose and interval to surgery, downstaging, and RT-related toxicity. Subgroup analysis according to primary tumor stage was also performed. Results: 1028 patients were analysed. All patients received combined RCHT with (364) or without (664) a RT boost. Patients underwent surgery after a median 10 weeks (IQ range 5–28). The overall pCR rate was 21.5 %. In the boost and no-boost groups, the pCR was 26.6 % (97) and 17 % (114) (p = 0.00), respectively. As a subgroup analysis, the pCR stratified by interval to surgery was 10 %, 23 %, 26.3 %, and 39.3 % (p < 0.000) in the boost group versus 10.6 %, 20.8 %, 19.3 %, and 20.4 % (p = 0.018) in the no-boost group. cT3 patients operated on ≥ week 11 and cT4 patients, regardless of time to surgery, received a significant benefit by the RT boost in terms of pCR rate. Patients in the boost group had a higher rate of grade ≥ 3 acute gastrointestinal toxicities (6 % vs. 1.7 %; p = 0.003). Conclusion: Our results suggest that RT dose intensification (boost) in LARC might significantly increase the pCR rate, although with a small increase in acute toxicity. While pCR seems only partially improved by prolonged time to surgery in the no-boost group, a progressive and significant pCR improvement in patients treated with boost over time was observed. RT boost seems to be beneficial only in more advanced primary tumors. © 2024 Elsevier B.V.

Style	Citing Format
MLA	Nicosia L, et al.. "Analysis of Patients With Locally Advanced Rectal Cancer Given Neoadjuvant Radiochemotherapy With or Without Rt Dose Intensification: A Multicenter Retrospective Study – Atlantis Part I." Radiotherapy and Oncology, vol. 204, no. , 2025, pp. -.
APA	Nicosia L, Bonu ML, Angelicone I, Lunardi G, Niespolo RM, Zannetti M, Agolli L, Chiloiro G, Romano A, Jafari F, Aghili M, Ghalehtaki R, Montesi G, De Felice F, De Renzi F, Magli A, Le Guevelou J, Lupattelli M, Minniti G, ... Osti MF (2025). Analysis of Patients With Locally Advanced Rectal Cancer Given Neoadjuvant Radiochemotherapy With or Without Rt Dose Intensification: A Multicenter Retrospective Study – Atlantis Part I. Radiotherapy and Oncology, 204(), -.
Chicago	Nicosia L, Bonu ML, Angelicone I, Lunardi G, Niespolo RM, Zannetti M, Agolli L, et al.. "Analysis of Patients With Locally Advanced Rectal Cancer Given Neoadjuvant Radiochemotherapy With or Without Rt Dose Intensification: A Multicenter Retrospective Study – Atlantis Part I." Radiotherapy and Oncology 204, no. (2025): -.
Harvard	Nicosia L et al. (2025) 'Analysis of Patients With Locally Advanced Rectal Cancer Given Neoadjuvant Radiochemotherapy With or Without Rt Dose Intensification: A Multicenter Retrospective Study – Atlantis Part I', Radiotherapy and Oncology, 204(), pp. -.
Vancouver	Nicosia L, Bonu ML, Angelicone I, Lunardi G, Niespolo RM, Zannetti M, et al.. Analysis of Patients With Locally Advanced Rectal Cancer Given Neoadjuvant Radiochemotherapy With or Without Rt Dose Intensification: A Multicenter Retrospective Study – Atlantis Part I. Radiotherapy and Oncology. 2025;204():-.
BibTex	@article{ author = {Nicosia L and Bonu ML and Angelicone I and Lunardi G and Niespolo RM and Zannetti M and Agolli L and Chiloiro G and Romano A and Jafari F and Aghili M and Ghalehtaki R and Montesi G and De Felice F and De Renzi F and Magli A and Le Guevelou J and Lupattelli M and Minniti G and Gambacorta MA and Habermehl D and Franco P and Arcangeli S and Buglione M and Alongi F and Osti MF}, title = {Analysis of Patients With Locally Advanced Rectal Cancer Given Neoadjuvant Radiochemotherapy With or Without Rt Dose Intensification: A Multicenter Retrospective Study – Atlantis Part I}, journal = {Radiotherapy and Oncology}, volume = {204}, number = {}, pages = {-}, year = {2025} }
RIS	TY - JOUR AU - Nicosia L AU - Bonu ML AU - Angelicone I AU - Lunardi G AU - Niespolo RM AU - Zannetti M AU - Agolli L AU - Chiloiro G AU - Romano A AU - Jafari F AU - Aghili M AU - Ghalehtaki R AU - Montesi G AU - De Felice F AU - De Renzi F AU - Magli A AU - Le Guevelou J AU - Lupattelli M AU - Minniti G AU - Gambacorta MA AU - Habermehl D AU - Franco P AU - Arcangeli S AU - Buglione M AU - Alongi F AU - Osti MF TI - Analysis of Patients With Locally Advanced Rectal Cancer Given Neoadjuvant Radiochemotherapy With or Without Rt Dose Intensification: A Multicenter Retrospective Study – Atlantis Part I JO - Radiotherapy and Oncology VL - 204 IS - SP - EP - PY - 2025 ER -

Science Communicator Platform

Authors

Authors Affiliations

Abstract