Radiation boost for synchronous solitary inguinal lymph node metastasis during neoadjuvant chemoradiotherapy for locally advanced rectal cancer

Abstract Background Some patients with locally advanced rectal cancer (LARC) present with inguinal lymph node metastases without evidence of other systemic disease, known as solitary inguinal lymph node metastasis (SILNM). These patients may represent a distinct subset who have a more favorable prog...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Mo Chen, Shuai Liu, Meng Xu, Han-chen Yi, Yanping Liu, Fang He
Formato:	article
Lenguaje:	EN
Publicado:	Springer 2021
Materias:	Solitary inguinal lymph node Radiation boost Neoadjuvant chemoradiotherapy Rectal cancer Synchronous Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/7871da1f997e44a291d4255009d15198
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:7871da1f997e44a291d4255009d15198
record_format	dspace
spelling	oai:doaj.org-article:7871da1f997e44a291d4255009d151982021-12-05T12:26:29ZRadiation boost for synchronous solitary inguinal lymph node metastasis during neoadjuvant chemoradiotherapy for locally advanced rectal cancer10.1007/s12672-021-00455-02730-6011https://doaj.org/article/7871da1f997e44a291d4255009d151982021-12-01T00:00:00Zhttps://doi.org/10.1007/s12672-021-00455-0https://doaj.org/toc/2730-6011Abstract Background Some patients with locally advanced rectal cancer (LARC) present with inguinal lymph node metastases without evidence of other systemic disease, known as solitary inguinal lymph node metastasis (SILNM). These patients may represent a distinct subset who have a more favorable prognosis and should be treated with curative intent. The optimal treatment strategy for these patients has not been determined. Methods We retrospectively reviewed 16 consecutive LARC patients diagnosed between January 2017 and December 2019, who had SILNM, were treated with an inguinal lymph nodes (ILN) radiation boost with curative intent during neoadjuvant chemoradiotherapy (nCRT) and underwent total mesorectal excision (TME). We used Kaplan–Meier survival curves to calculate survival rates, and recorded radiation-related toxicity. Results None of these 16 patients developed pelvic or inguinal recurrences, and 3 of the patients developed distant metastases. The 3-year overall survival rate and locoregional relapse-free survival rate were both 100%. The 3-year disease-free rate and distant metastasis-free survival rate were both 81.3%. Of 5 patients who had ILN dissection for suspicious ILNs after neoadjuvant treatment, 2 had residual nodal tumor confirmed. Grade 3 toxicity was found in 5 patients, and no patients had lymphedema or other grade 4 or 5 toxicities. Conclusions In LARC patients with synchronous SILNM, a radiation boost to the ILNs during nCRT achieved excellent local control with acceptable toxicity. Though the optimal treatment strategy remains unclear, nCRT with an ILN radiation boost prior to TME may be a reasonable therapeutic approach to consider for this subset of patients.Mo ChenShuai LiuMeng XuHan-chen YiYanping LiuFang HeSpringerarticleSolitary inguinal lymph nodeRadiation boostNeoadjuvant chemoradiotherapyRectal cancerSynchronousNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENDiscover Oncology, Vol 12, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Solitary inguinal lymph node Radiation boost Neoadjuvant chemoradiotherapy Rectal cancer Synchronous Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Solitary inguinal lymph node Radiation boost Neoadjuvant chemoradiotherapy Rectal cancer Synchronous Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Mo Chen Shuai Liu Meng Xu Han-chen Yi Yanping Liu Fang He Radiation boost for synchronous solitary inguinal lymph node metastasis during neoadjuvant chemoradiotherapy for locally advanced rectal cancer
description	Abstract Background Some patients with locally advanced rectal cancer (LARC) present with inguinal lymph node metastases without evidence of other systemic disease, known as solitary inguinal lymph node metastasis (SILNM). These patients may represent a distinct subset who have a more favorable prognosis and should be treated with curative intent. The optimal treatment strategy for these patients has not been determined. Methods We retrospectively reviewed 16 consecutive LARC patients diagnosed between January 2017 and December 2019, who had SILNM, were treated with an inguinal lymph nodes (ILN) radiation boost with curative intent during neoadjuvant chemoradiotherapy (nCRT) and underwent total mesorectal excision (TME). We used Kaplan–Meier survival curves to calculate survival rates, and recorded radiation-related toxicity. Results None of these 16 patients developed pelvic or inguinal recurrences, and 3 of the patients developed distant metastases. The 3-year overall survival rate and locoregional relapse-free survival rate were both 100%. The 3-year disease-free rate and distant metastasis-free survival rate were both 81.3%. Of 5 patients who had ILN dissection for suspicious ILNs after neoadjuvant treatment, 2 had residual nodal tumor confirmed. Grade 3 toxicity was found in 5 patients, and no patients had lymphedema or other grade 4 or 5 toxicities. Conclusions In LARC patients with synchronous SILNM, a radiation boost to the ILNs during nCRT achieved excellent local control with acceptable toxicity. Though the optimal treatment strategy remains unclear, nCRT with an ILN radiation boost prior to TME may be a reasonable therapeutic approach to consider for this subset of patients.
format	article
author	Mo Chen Shuai Liu Meng Xu Han-chen Yi Yanping Liu Fang He
author_facet	Mo Chen Shuai Liu Meng Xu Han-chen Yi Yanping Liu Fang He
author_sort	Mo Chen
title	Radiation boost for synchronous solitary inguinal lymph node metastasis during neoadjuvant chemoradiotherapy for locally advanced rectal cancer
title_short	Radiation boost for synchronous solitary inguinal lymph node metastasis during neoadjuvant chemoradiotherapy for locally advanced rectal cancer
title_full	Radiation boost for synchronous solitary inguinal lymph node metastasis during neoadjuvant chemoradiotherapy for locally advanced rectal cancer
title_fullStr	Radiation boost for synchronous solitary inguinal lymph node metastasis during neoadjuvant chemoradiotherapy for locally advanced rectal cancer
title_full_unstemmed	Radiation boost for synchronous solitary inguinal lymph node metastasis during neoadjuvant chemoradiotherapy for locally advanced rectal cancer
title_sort	radiation boost for synchronous solitary inguinal lymph node metastasis during neoadjuvant chemoradiotherapy for locally advanced rectal cancer
publisher	Springer
publishDate	2021
url	https://doaj.org/article/7871da1f997e44a291d4255009d15198
work_keys_str_mv	AT mochen radiationboostforsynchronoussolitaryinguinallymphnodemetastasisduringneoadjuvantchemoradiotherapyforlocallyadvancedrectalcancer AT shuailiu radiationboostforsynchronoussolitaryinguinallymphnodemetastasisduringneoadjuvantchemoradiotherapyforlocallyadvancedrectalcancer AT mengxu radiationboostforsynchronoussolitaryinguinallymphnodemetastasisduringneoadjuvantchemoradiotherapyforlocallyadvancedrectalcancer AT hanchenyi radiationboostforsynchronoussolitaryinguinallymphnodemetastasisduringneoadjuvantchemoradiotherapyforlocallyadvancedrectalcancer AT yanpingliu radiationboostforsynchronoussolitaryinguinallymphnodemetastasisduringneoadjuvantchemoradiotherapyforlocallyadvancedrectalcancer AT fanghe radiationboostforsynchronoussolitaryinguinallymphnodemetastasisduringneoadjuvantchemoradiotherapyforlocallyadvancedrectalcancer
_version_	1718371909336301568

Radiation boost for synchronous solitary inguinal lymph node metastasis during neoadjuvant chemoradiotherapy for locally advanced rectal cancer

Ejemplares similares