Preoperative chemoradiation using oral capecitabine in locally advanced rectal cancer. International journal of radiation oncology, biology, physics. [Int J Radiat Oncol Biol Phys] Journal article | | Title | Preoperative chemoradiation using oral capecitabine in locally advanced rectal cancer. | | Author(s) | Kim JS, Kim JS, Cho MJ, Song KS, Yoon WH | | Institution | Department of Therapeutic Radiology, College of Medicine, Chungnam National University, Jung-gu, Taejon, South Korea. | | Source | Int J Radiat Oncol Biol Phys 2002 Oct 1; 54(2):403-8. | | MeSH | Adenocarcinoma
Administration, Oral
Adult
Aged
Aged, 80 and over
Antimetabolites, Antineoplastic
Deoxycytidine
Drug Administration Schedule
Female
Humans
Leucovorin
Male
Middle Aged
Neoplasm Staging
Radiotherapy Dosage
Rectal Neoplasms
Research Support, Non-U.S. Gov't
| | Abstract | PURPOSE: Capecitabine (Xeloda) is a new orally administered fluoropyrimidine carbamate that was rationally designed to exert its effect by tumor-selective activation. We attempted to evaluate the efficacy and toxicity of preoperative chemoradiation using capecitabine in locally advanced rectal cancer.
METHODS AND MATERIALS: Between July 1999 and March 2001, 45 patients with locally advanced rectal cancer (cT3/T4 or N+) were treated with preoperative chemoradiation. Radiation of 45 Gy/25 fractions was delivered to the pelvis, followed by a 5.4 Gy/3 fractions boost to the primary tumor. Chemotherapy was administered concurrent with radiotherapy and consisted of 2 cycles of 14-day oral capecitabine (1650 mg/m(2)/day) and leucovorin (20 mg/m(2)/day), each of which was followed by a 7-day rest period. Surgery was performed 6 weeks after the completion of chemoradiation.
RESULTS: Thirty-eight patients received definitive surgery. Primary tumor and node downstaging occurred in 63% and 90% of patients, respectively. The overall downstaging rate, including both primary tumor and nodes, was 84%. A pathologic complete response was achieved in 31% of patients. Twenty-one patients had tumors located initially 5 cm or less from the anal verge; among the 18 treated with surgery, 72% received sphincter-preserving surgery. No Grade 3 or 4 hematologic toxicities developed. Other Grade 3 toxicities were as follows: hand-foot syndrome (7%), fatigue (4%), diarrhea (4%), and radiation dermatitis (2%).
CONCLUSION: These preliminary results suggest that preoperative chemoradiation with capecitabine is a safe, well-tolerated, and effective neoadjuvant treatment modality for locally advanced rectal cancer. In addition, this preoperative treatment has a considerable downstaging effect on the tumor and can increase the possibility of sphincter preservation in distal rectal cancer. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 12243814 |
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