Long-term outcomes of neoadjuvant radiotherapy of rectal cancer during the novel coronavirus pandemic. Multicenter retrospective cohort study using propensity score matching

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Background. Neoadjuvant radiotherapy remains the standard treatment for patients with rectal cancer; however, the choice between short-course radiotherapy (25 Gy in 5 fractions) and long-course chemoradiotherapy (50–54 Gy with fluoropyrimidines) remains debatable. During the COVID-19 pandemic, the need for comparative assessment of these modalities increased due to the necessity of optimizing treatment under conditions of increased burden on the healthcare system. Aim. To compare long-term outcomes of neoadjuvant radiotherapy in patients with non-metastatic rectal cancer depending on the radiotherapy regimen during the COVID-19 pandemic. Materials and methods. A multicenter retrospective cohort study was performed. Propensity score matching at a 1:1 ratio was used to adjust for observed confounders. The primary endpoint was 2-year recurrence-free survival; the secondary endpoint was 2-year overall survival. Results. After propensity score matching, 94 patients were analyzed in each group. Two-year recurrence-free survival in the short-course group was 81.9 % (95 % confidence interval (CI) 74.4–90) compared to 76.6 % (95 % CI 68.5–85.7) in the chemoradiation group (p = 0.464). Two-year overall survival reached 95.7 % (95 % CI 91.7–99.9) and 94.6 % (95 % CI 90.1–99.3), respectively (p = 0.941). No statistically significant differences in survival outcomes were observed between the groups. Conclusion. Short-course radiotherapy and long-course chemoradiotherapy demonstrate comparable long-term outcomes in patients with non-metastatic rectal cancer. Definitive conclusions can be made with a longer follow-up.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.