Reference : Preoperative hyperfractionated accelerated radiotherapy (HART) in locally advanced re...
Scientific journals : Article
Human health sciences : Oncology
Preoperative hyperfractionated accelerated radiotherapy (HART) in locally advanced rectal cancer (LARC) immediately followed by surgery. A prospective phase II trial
Coucke, Philippe mailto [Hôpital Maisonneuve-Rosemont, Montreal > Radiation-Oncology > > >]
Notter [> >]
Stamm [Kantonspital Aarau, Aarau > > > >]
Stamm [Kantonspital Aarau, Aarau > > > >]
Matter [> >]
Fasolini [Kantonspital Aarau, Aarau > > > >]
Schlumpf [Kantonspital Aarau, Aarau > > > >]
Matzinger [Centre Hospitalier Universitaire Vaudois > > > >]
bouzourene [ > > ]
Radiotherapy & Oncology
Elsevier Scientific
Yes (verified by ORBi)
[en] Background and purpose

We aim to report on local control in a phase II trial on preoperative hyperfractionated and accelerated radiotherapy schedule (HART) in locally advanced resectable rectal cancer (LARC). This fractionation schedule was designed to keep the overall treatment time (OTT) as short as possible.
Patients and methods

This is a prospective trial on patients with UICC stages II and III rectal cancer. The patients were submitted to a total dose of 41.6 Gy, delivered in 2.5 weeks at 1.6 Gy per fraction twice a day with a 6-h interfraction interval. Surgery was performed within 1 week after the end of irradiation. Adjuvant chemotherapy was delivered in a subset of patients.

Two hundred and seventy nine patients were entered and 250 are fully assessable, with a median follow-up of 39 months. The 5-years actuarial local control (LC) rate is 91.7%. The overall survival (OS) is 59.6%. The freedom from disease relapse (FDR) is 71.5%. Downstaging was observed in 38% of the tumors.

The actuarial LC at 5 years is 91.7%, although we are dealing with stages II–III LARC, mainly located in the lower rectum (median distance=5 cm). The pattern of failure is dominated by distant metastases and treatment intensification will obviously require a systemic approach.
Researchers ; Professionals ; Students ; General public ; Others

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