Abstract
BACKGROUND: For patients with T3/T4N0, T(any)N+, or locally unresectable rectal cancer, the treatment approach involves preoperative chemoradiation (CRT) followed by radical surgical resection. Our objective was to identify the predictive factors associated with favorable pathologic response in these individuals. METHODS: We analyzed data from patients diagnosed with primary rectal cancer who underwent preoperative chemoradiation (CRT) followed by radical surgery at Changhua Christian Hospital. Information regarding patient demographics, clinical and pathological characteristics, laboratory data collected at baseline and during CRT, as well as perioperative details, was extracted from medical records. These patients were categorized into good-responder and poor-responder groups. We employed Kaplan-Meier curve analysis to evaluate overall survival (OS) and disease-free survival (DFS), and logistic regression to assess the variables related to treatment response. RESULTS: Overall, 98 patients were enrolled. A strong pathological response to preoperative CRT correlated with improved OS and DFS among patients with locally advanced rectal cancer. The introduction of simultaneous integrated boost (SIB) in long-course radiotherapy (RT) enhanced the pathological response while maintaining manageable acute toxicity. CONCLUSIONS: Implementing SIB in long-course RT enhances treatment response while maintaining acceptable acute toxicity. Further studies are required to identify additional predictive factors.