Comparing the effectiveness of chemotherapy drugs in neoadjuvant chemoradiotherapy protocols on the survival rate of locally advanced rectal cancer- a retrospective cohort study

Abstract

Introduction: Rectal cancer remains a major health problem worldwide. Patients are usually diagnosed at advanced stages of the disease and the prognosis is poor. Fluoropyrimidine-containing regimens are recommended for standard treatment of locally advanced rectal cancer in the neoadjuvant setting, but the treatment of locally advanced rectal cancer is still a challenge. Aim: The aim of this study was to compare the effectiveness of chemotherapy drugs in neoadjuvant chemoradiotherapy on the survival rate of locally advanced rectal cancer.Materials and Methods: In this study, patients with rectal cancer who referred to the medical centers of Tabriz University of Medical Sciences (2007-2016) were studied (entire census). Demographic information, cancer stage, treatment methods and outcome of the patients were recorded in the prepared form. And will be statistically analyzed. pvalue less than 0.05 was considered statistically significant.Results: There were 219 cases with a mean age of 55.84 ± 13.9 years, 64% were male, 19.6% were smokers, and 42.5% were under high school. Pathological examination of all samples was adenocarcinoma. More than 77% of patients received concurrent chemoradiotherapy. There was no relationship between patient characteristics and cancer mass with the treatment method (P>0.05). One-, three-, and five-year survival rates among rectal cancer patients were 61%, 74%, and 93%, respectively. Five-year survival rates in patients receiving concurrent radiotherapy with chemotherapy were 64% and 51% without chemotherapy (p<0.05), and five-year survival rates in those receiving capecitabine and fluorouracil plus radiotherapy were 62% and 64%, respectively (p>0.05).Conclusion: The use of chemotherapy drugs concomitantly with neoadjuvant therapy improves survival rates in patients with locally advanced rectal cancer, while the type of drug used does not affect survival rates.