A modern regimen of pre-operative concurrent chemo-radiation therapy in locally advanced rectal cancer

被引:12
作者
Bazarbashi, Shouki [1 ]
El-Bassiouni, Mazen [1 ]
Abdelsalam, Mahmoud [1 ]
Soudy, Hussein [1 ]
Al Sanea, Nasser [2 ]
Jabbar, Alaa Abdul [2 ]
Manji, Mohamed [3 ]
Fagih, Mosa [4 ]
Ajarim, Dahish [1 ]
机构
[1] King Faisal Specialist Hosp & Res Ctr, Dept Med Oncol, Riyadh 11211, Saudi Arabia
[2] King Faisal Specialist Hosp & Res Ctr, Dept Surg, Riyadh 11211, Saudi Arabia
[3] King Faisal Specialist Hosp & Res Ctr, Dept Radiat Oncol, Riyadh 11211, Saudi Arabia
[4] King Faisal Specialist Hosp & Res Ctr, Dept Pathol & Lab Med, Sect Anatom Pathol, Riyadh 11211, Saudi Arabia
关键词
rectal cancer; capecitabine; preoperative radiation therapy;
D O I
10.1002/jso.21097
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To evaluate the efficacy and toxicity of preoperative concurrent capecitabine and radiotherapy in the treatment of resectable locally advanced rectal cancer(LARC). Materials and Methods: We conducted a phase II trial to assess pathological complete response, tumor downstaging, toxicity and survival of capecitabine (825 mg/m(2)) orally, twice daily) with radiotherapy (50.4 Gy/28 fractions) in 31 patients with LARC (cT3/T4 or N+) staged by endoscopic ultrasound (EUS). Results: Median age was 53 years; with M:F ratio of 1:1.58; 77.4% had Eastern Cooperative Oncology Group performance status of I. EUS showed that 67.7% of tumors were T3, 19.4% were T4, and 58% were mode positive. Of 30 patients who had surgery. 6.5% achieved pathological complete remission (pCR). Tumor and nodal downstating were achieved in 53.9% and 50% of patients. respectively. Grade 3/4 toxicities were mainly diarrhea (35.5%) and proctitis (32.3%). Sphincter preservation was achieved in 4/21 (15%) of patients initially planned for abdominoperineal resection, The median follow-up was 46 nionths (Range: 1.47-63.9), and the 3-year disease-free and overall survival were 59.8% and 76.6%, respectively, Conclusion: Capecitabine given concurrently with radiation therapy is generally well tolerated, and proved to be an effective radiosensitizer in the neoadjuvant treatement of locally advanced rectal cancer, yielding results comparable to those reported with 5-FU.
引用
收藏
页码:167 / 174
页数:8
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