Evaluation of the Efficacy of Modified De Gramont and Modified FOLFOX4 Regimens for Adjuvant Therapy of Locally Advanced Rectal Cancer

Objective: To evaluate the efficacy of modified De Gramont (mDG) and FOLFOX4 (mFOLFOX4) regimens in patients with locally advanced rectal cancer (LARC). Methods: Patients that received adjuvant chemotherapy (CT) for the treatment of LARC (stage II and III) were retrospectively evaluated. Results: A total of 231 patients were examined. Median age was 58 (range, 18-83) and, of these patients, 36 (15.6%) had stage II and 195 (84.4%) had stage III disease. While the patients with stage II disease received only mDG regimen (36, 100.0%), of the patients with stage III disease, 71 (36.5%) received mDG and 124 (63.5%) received mFOLFOX4 regimen. Patients with stage III disease showed recurrences more often, but this difference was not statistically significant. Similarly, for the patients with stage III disease, there was no statistically significant relation between the adjuvant CT regimen received and the rate of recurrence. In patients with stage II disease, who received mDG, median DFS was 101 months and median OS was 106 months. For the patients with stage III disease, the patients that received mDG showed a median DFS of 78 months and a median OS of 96 months, while the patients that received mFOLFOX4 had a median DFS of 51 months and a median OS of 78 months. Although, for the patients with stage III disease, there are major differences between the two different regimens of CT in terms of DFS and OS, this difference was not statistically significant. When the results were evaluated from the perspective of toxicity, the patients that received mFOLFOX4 showed more toxicity. Neurotoxicity, which was seen in the patients that were given mFOLFOX4, was the most prominent toxicity. Conclusions: mDG and mFOLFOX4 regimens are applicable regimens as adjuvant CT for the treatment of LARC.