The Updated Results for the Phase 3 Study of 5×5 Gy Followed By Chemotherapy in Locally Advanced Rectal Cancer (STELLAR trial)

Jin, Jie; Liu, S.; Zhu, Yuan; Wang, W.; Wang, Xianding; Wang, J.; Li, G.; Fan, Lin; Zhang, K.; Shi, Mei; Li, S.; Li, N.; Zhang, H.; Wang, X.; Chi, Yujia; Zhang, H.; Jiang, Longying; Jiang, Jason; Zou, Shuangmei; Ren, Hua; Fang, Hui; Song, Yong-Wen; Liu, Y.; Wang, Suqiong; Chen, B.; Tang, Yuan; Qi, Shulong; Liu, Ningning; Li, Y.

doi:10.1016/j.ijrobp.2017.06.976

Cited by 16 publications

(20 citation statements)

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“…After a median follow-up of 59 months, patients who received consolidation chemotherapy were found to have improved DFS ( P < 0.05), and there were differences in survival between groups in patients who received at least one cycle of FOLFOX. In another phase III study [ 21 ] (STELLAR trial) in China, comparing short-course radiotherapy followed by chemotherapy with long-course chemoradiotherapy in LARC, the results showed that pCR rates in the experimental and control group were 18.6% vs. 5.4% ( P = 0.029), respectively. These findings were consistent with the pCR rates reported in this study (18.1–25%).…”

Section: Discussionmentioning

confidence: 99%

Comparing neoadjuvant long-course chemoradiotherapy with short-course radiotherapy in rectal cancer

et al. 2021

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Background The purpose of this study was to compare short-course radiotherapy (SC) or neoadjuvant long-course chemoradiotherapy (LC) treatment for locally advanced rectal cancer patients. Methods Patients with a diagnosis of locally advanced rectal cancer (LARC) who had undergone neoadjuvant radiotherapy before surgery between 2013 and 2018 at the medical center in China were included in this study. All patients’ MRI confirmed T2N+M0 or T3-4N0-3M0 clinical stages. Patients in the SC group received pelvic radiotherapy with a dose of 5 × 5 Gy (with or without chemotherapy at any time), followed by immediate or delayed surgery. Patients in the LC group received a dose of 50–50.4 Gy in 25–28 fractions, concomitantly with FOLFOX or capecitabine-based chemotherapy, followed by surgery 4–6 weeks later. All clinical data were retrospectively collected, and long-term follow-up was completed and recorded at the same time. Results A total of 170 were eligible to participate in this study, 32 patients in the SC group, and 138 in the LC group. The median follow-up time of living patients was 39 months. The disease-free survival (DFS) and overall survival (OS) rates in the SC group and LC group at 3 years, were, 84.9% versus 72.4% (P = 0.273) and 96.2% versus 87.2% (P = 0.510), respectively. The complete pathological response (pCR) rates in the SC group and LC group were, 25% versus 18.1% (the difference was not statistically significant, P = 0.375), respectively. However, the SC group had better node(N) downstaging compared to the LC group (P = 0.011). Conclusions There were no differences observed in DFS and OS between short-course radiotherapy and long-course chemoradiation, and both can be used as treatment options for patients with locally advanced rectal cancer.

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Section: Discussionmentioning

confidence: 99%

Comparing neoadjuvant long-course chemoradiotherapy with short-course radiotherapy in rectal cancer

et al. 2021

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“…The locoregional failure rates (8.7% vs 6.0%; P = .10) and quality of life were similar between the two arms. The full manuscript of the RAPIDO trial and results of the STELLAR trial are awaited 29 . During the COVID pandemic, while the patient awaits surgery after SCRT, consolidation chemotherapy may be added and, to reduce toxicity, dose reductions may be considered.…”

Section: Discussionmentioning

confidence: 99%

Radiotherapy management of rectal cancer in the backdrop of the COVID pandemic

Lewis

Talapatra

2020

Cancer Reports

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Background COVID‐19 outbreak was declared as a pandemic by the World Health Organization in March 2020. Over the last 3 months, the pandemic has challenged the diagnosis and treatment of all cancer, including rectal cancer. Constraints in resources call for a change in the treatment strategy without compromising efficacy. Recent Findings Delivery of shorter treatment schedules for radiotherapy offers advantages like short overall treatment time, improved throughput on the machine, improved compliance and reduced risk of transmission of COVID 19. Other strategies include delaying surgery, reducing the intensity of chemotherapy and adoption of organ preservation approach. Conclusion The curative treatment of rectal cancer should not be hindered during the COVID pandemic, and modifications in the multi‐modality treatment will help achieve quality care.

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“…10 A longer interval from radiation to surgery results in greater tumor downstaging for both SCRT 10 and LCCRT. 14 Furthermore, the incorporation of SCRT into TNT has been evaluated with promising results, [15][16][17][18][19] and although still under active investigation, 20,21 our colorectal disease management team concluded that delivering TNT with SCRT off-trial is reasonable and necessary given the ongoing COVID-19 pandemic. Admittedly, other potential differences between SCRT and LCCRT have not yet been fully understood (eg, in the context of nonoperative management and long-term anal sphincter function).…”

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confidence: 99%

Prostate Cancer Radiation Therapy Recommendations in Response to COVID-19

Zaorsky¹,

Yu²,

McBride³

et al. 2020

Advances in Radiation Oncology

156

145

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The COVID-19 pandemic will consume significant health care resources. Given the concerns for rapidly increasing infection rates in the United States, impending staffing shortages, and the potential for resource reallocation, we rapidly reevaluated our rectal cancer practice policies during this public health emergency. Before the pandemic, we commonly used total neoadjuvant therapy with a strong preference for long-course chemoradiation. In the setting of the ongoing pandemic, we now mandate short-course radiation therapy (SCRT). Despite multiple randomized trials demonstrating no difference in locoregional recurrence, distant recurrence, or overall survival between SCRT and long-course chemoradiation, the adaptation of SCRT in the United States has been low given concerns for less tumor downstaging and increased toxicity. In the setting of the ongoing and likely prolonged COVID-19 pandemic, we feel that these concerns must be reevaluated, because SCRT presents a well-validated alternative that will allow us to meet the needs of a greater number of potentially curable patients at a time when resources are severely and acutely constrained.

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The Updated Results for the Phase 3 Study of 5×5 Gy Followed By Chemotherapy in Locally Advanced Rectal Cancer (STELLAR trial)

Cited by 16 publications

References 0 publications

Comparing neoadjuvant long-course chemoradiotherapy with short-course radiotherapy in rectal cancer

Comparing neoadjuvant long-course chemoradiotherapy with short-course radiotherapy in rectal cancer

Radiotherapy management of rectal cancer in the backdrop of the COVID pandemic

Prostate Cancer Radiation Therapy Recommendations in Response to COVID-19

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