BACKGROUND: Preoperative radiation therapy in combination with 5-fluoracil (5-FU) improves local tumour control in locally advanced rectal cancer. The aim of our study was to evaluate the toxicity and efficacy of preoperative chemoradiation using the oral 5-FU prodrug capecitabine in locally advanced rectal cancer. METHODS: Sixty patients with locally advanced rectal cancer were treated with preoperative chemoradiation. Radiotherapy consisted of a total dose of 50 Gy delivered in 25 fractions to the pelvis. Chemotherapy was concurrently administered and consisted of oral capecitabine only on radiotherapy days. Surgery was performed six to ten weeks after completion of chemoradiation. RESULTS: The patient population consisted of 19 females and 41 males, with a median age of 61 years. All but two patients received the full dose of chemoradiation. No grade 3 or 4 haematological toxicities developed. Two patients (3%) developed grade 3 radiation dermatitis and one a grade 3 diarrhoea. All patients underwent definitive surgery; 19 patients underwent an abdominal perineal resection (APR), 25 a low anterior resection (LAR) and 16 patients a Hartmann's procedure. One patient with a low anterior resection developed an anastomotic leakage (4%). Final pathology demonstrated eight patients (13%) with a complete pathological response. Primary tumour and nodal downstaging occurred in 67 and 84% of the patients, respectively. Two patients (3%) had an R1 resection, one after an APR and one after an LAR. CONCLUSION: Preoperative chemoradiation with oral capecitabine is safe and well tolerated in locally advanced rectal cancer patients. This preoperative treatment has a considerable downstaging effect on the tumour and lymph nodes.
BACKGROUND: Preoperative radiation therapy in combination with 5-fluoracil (5-FU) improves local tumour control in locally advanced rectal cancer. The aim of our study was to evaluate the toxicity and efficacy of preoperative chemoradiation using the oral 5-FU prodrug capecitabine in locally advanced rectal cancer. METHODS: Sixty patients with locally advanced rectal cancer were treated with preoperative chemoradiation. Radiotherapy consisted of a total dose of 50 Gy delivered in 25 fractions to the pelvis. Chemotherapy was concurrently administered and consisted of oral capecitabine only on radiotherapy days. Surgery was performed six to ten weeks after completion of chemoradiation. RESULTS: The patient population consisted of 19 females and 41 males, with a median age of 61 years. All but two patients received the full dose of chemoradiation. No grade 3 or 4 haematological toxicities developed. Two patients (3%) developed grade 3 radiation dermatitis and one a grade 3 diarrhoea. All patients underwent definitive surgery; 19 patients underwent an abdominal perineal resection (APR), 25 a low anterior resection (LAR) and 16 patients a Hartmann's procedure. One patient with a low anterior resection developed an anastomotic leakage (4%). Final pathology demonstrated eight patients (13%) with a complete pathological response. Primary tumour and nodal downstaging occurred in 67 and 84% of the patients, respectively. Two patients (3%) had an R1 resection, one after an APR and one after an LAR. CONCLUSION: Preoperative chemoradiation with oral capecitabine is safe and well tolerated in locally advanced rectal cancerpatients. This preoperative treatment has a considerable downstaging effect on the tumour and lymph nodes.
Authors: C Grávalos; P García-Alfonso; R Afonso; V Arrazubi; A Arrivi; J C Cámara; J Capdevila; A Gómez-España; A Lacasta; J L Manzano; M Salgado; J Sastre; E Díaz-Rubio Journal: Clin Transl Oncol Date: 2011-12 Impact factor: 3.405
Authors: Guus M J Bökkerink; Eelco J R de Graaf; Cornelis J A Punt; Iris D Nagtegaal; Heidi Rütten; Joost J M E Nuyttens; Esther van Meerten; Pascal G Doornebosch; Pieter J Tanis; Eric J Derksen; Roy S Dwarkasing; Corrie A M Marijnen; Annemieke Cats; Rob A E M Tollenaar; Ignace H J T de Hingh; Harm J T Rutten; George P van der Schelling; Albert J Ten Tije; Jeroen W A Leijtens; Guido Lammering; Geerard L Beets; Theo J Aufenacker; Apollo Pronk; Eric R Manusama; Christiaan Hoff; Andreas J A Bremers; Cornelelis Verhoef; Johannes H W de Wilt Journal: BMC Surg Date: 2011-12-15 Impact factor: 2.102
Authors: Wijnand J Alberda; Helene P N Dassen; Roy S Dwarkasing; François E J A Willemssen; Anne E M van der Pool; Johannes H W de Wilt; Jacobus W A Burger; Cornelis Verhoef Journal: Int J Colorectal Dis Date: 2012-09-22 Impact factor: 2.571
Authors: Mostafa Abd Elwanis; Doaa W Maximous; Mohamed Ibrahim Elsayed; Nabiel N H Mikhail Journal: World J Surg Oncol Date: 2009-06-09 Impact factor: 2.754