Neoadjuvant short-course hyperfractionated accelerated radiotherapy (SC-HART) combined with S-1 for locally advanced rectal cancer

The purpose of this study was to examine the safety and feasibility of a novel protocol of neoadjuvant shortcourse hyperfractionated accelerated radiotherapy (sc-hart) combined with s-1 for locally advanced rectal cancer. a total of 56 patients with lower rectal cancer of ct3n1m0 (stage 3 b) was treated with sc-hart followed by radical surgery,and were analyzed in the present study. sc-hart was performed with a dose of 2.5 gy twice daily,with an interval of at least 6 hours between fractions,up to a total dose of 25 gy (25 gy in 10 fractions for 5 days) combined with s-1 for 10 days. radical surgery was performed within three weeks following the end of the sc-hart. the median age was 64.6 (range,39-85) years. the median follow-up term was 16.3 (range,2-53) months. of the 56 patients,53 (94.4%) had no apparent adverse events before surgery; 55 (98.2%) completed the full course of neoadjuvant therapy,while one patient stopped chemotherapy because of grade 3 gastrointestinal toxicity (ctcae v.3). the sphincter preservation rate was 94.6%. downstaging was observed in 45 patients (80.4%). adjuvant chemotherapy was administered to 43 patients (76.8%). the local control rate,disease-free survival rate and disease-specific survival rate were 100%,91.1% and 100%,respectively. to conclude,sc-hart combined with s-1 for locally advanced rectal cancer was well tolerated and produced good short-term outcomes. sc-hart therefore appeared to have a good feasibility for use in further clinical trials. © the author 2013. published by oxford university press on behalf of the japan radiation research society and japanese society for therapeutic radiology and oncology.