Irinotecan+5-fluorouracil with concomitant pre-operative radiotherapy in locally advanced non-resectable rectal cancer: a phase I/II study

被引:17
作者
Iles, S. M. [1 ]
Gollins, S. W. [2 ]
Susnerwala, S. [3 ]
Haylock, B. [4 ]
Myint, S. [4 ]
Biswas, A. [3 ]
Swindell, R. [5 ]
Levine, E. [1 ]
机构
[1] Christie Hosp NHS Trust, Dept Clin Oncol, Manchester M20 4BX, Lancs, England
[2] N Wales Canc Treatment Ctr, Dept Clin Oncol, Rhyi LL18 5UJ, Wales
[3] Royal Preston Hosp, Dept Clin Oncol, Preston PR2 9HT, Lancs, England
[4] Clatterbridge Ctr Oncol, Dept Clin Oncol, Liverpool CH63 4JY, Merseyside, England
[5] Christie Hosp NHS Trust, Dept Med Stat, Manchester M20 4BX, Lancs, England
关键词
chemotherapy; combined modality; irinotecan; locally advanced; radiation; rectal cancer;
D O I
10.1038/sj.bjc.6604292
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
In the UK, 10% of patients diagnosed with rectal cancer have inoperable disease at presentation. This study ascertained whether the resectability rate of inoperable locally advanced rectal cancer was improved by administration of intravenous irinotecan, 5-fluorouracil (5-FU) and pelvic radiotherapy. During phase I of the trial (n = 12), the dose of irinotecan was escalated in three-patient cohorts from 50 mg m(-2) to 60 mg m(-2) to 70 mg m(-2) to identify the maximum tolerated dose (60 mg m(-2)). In phase II, 31 patients with non-resectable disease received 45 Gy radiotherapy and 5-FU infusions (200 mg m(-2) per day) for 5 weeks. Irinotecan (60 mg m(-2)) was given on days 1, 8, 15 and 22. After treatment, patients were operated on if possible. Thirty patients completed the protocol, 28 underwent surgery. Before surgery, MRI restaging of 24 patients showed that 19 (79%) had a reduction in tumour stage after treatment (seven complete clinical response and 12 partial). Of 27 patients followed up after surgery, 22 (81%) had clear circumferential resection margins. Disease-free and overall survival estimates at 3 years were 65 and 90%, respectively. The regimen was well tolerated. Irinotecan, 5-FU and radiotherapy results in tumour downgrading, allowing resection of previously inoperable tumour with acceptable toxicity.
引用
收藏
页码:1210 / 1216
页数:7
相关论文
共 49 条
  • [1] ALONSO V, 2004, J CLIN ONCOL, V22
  • [2] ALONSO V, 2007, J CLIN ONCOL, V25
  • [3] A phase I-II study of weekly oxaliplatin, 5-fiuorouracil continuous infusion and preoperative radiotherapy in locally advanced rectal cancer
    Aschele, C
    Friso, ML
    Pucciarelli, S
    Lonardi, S
    Sartor, L
    Fabris, G
    Urso, EDL
    Del Bianco, P
    Sotti, G
    Lise, M
    Monfardini, S
    [J]. ANNALS OF ONCOLOGY, 2005, 16 (07) : 1140 - 1146
  • [4] Biweekly oxaliplatin, raltitrexed, 5-fluorouracil and folinic acid combination chemotherapy during preoperative radiation therapy for locally advanced rectal cancer: a phase I-II study
    Avallone, A.
    Delrio, P.
    Guida, C.
    Tatangelo, F.
    Petrillo, A.
    Marone, P.
    Cascini, L. G.
    Morrica, B.
    Lastoria, S.
    Parisi, V.
    Budillon, A.
    Comella, P.
    [J]. BRITISH JOURNAL OF CANCER, 2006, 94 (12) : 1809 - 1815
  • [5] Radiochemotherapy with short daily infusion of low-dose oxaliplatin, leucovorin, and 5-FU in T3-T4 unresectable rectal cancer: A phase II iattgi study
    Carraro, S
    Roca, EL
    Cartelli, C
    Rafailovici, L
    Odena, SC
    Wasserman, E
    Gualdrini, U
    Huertas, E
    Barugel, M
    Ballarino, G
    Rodriguez, MC
    Masciangioli, G
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2002, 54 (02): : 397 - 402
  • [6] CASADO E, 2004, J CLIN ONCOL, V23
  • [7] Phase II study of radiochemotherapy with UFT and low-dose oral leucovorin in patients with unresectable rectal cancer
    de la Torre, A
    Ramos, S
    Valcárcel, FJ
    Candal, A
    Regueiro, CA
    Romero, J
    Magallón, R
    Salinas, J
    de las Heras, M
    Veiras, C
    Tisaire, JL
    Aragón, G
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1999, 45 (03): : 629 - 634
  • [8] DeVita VT., 2001, CANC PRINCIPLES PRAC
  • [9] Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial
    Douillard, JY
    Cunningham, D
    Roth, AD
    Navarro, M
    James, RD
    Karasek, P
    Jandik, P
    Iveson, T
    Carmichael, J
    Alakl, M
    Gruia, G
    Awad, L
    Rougier, P
    [J]. LANCET, 2000, 355 (9209) : 1041 - 1047
  • [10] EFFECT OF PREOPERATIVE IRRADIATION ON RESECTABILITY OF COLORECTAL CARCINOMAS
    EMAMI, B
    PILEPICH, M
    WILLETT, C
    MUNZENRIDER, JE
    MILLER, HH
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1982, 8 (08): : 1295 - 1299