Walid Galal Elshazly1, Mohmed Farouk, Mohmed Samy. 1. Colorectal Unit, Surgical Department, Faculty of Medicine, University of Alexandria, Alexandria, Egypt. wshazly@hotmail.com
Abstract
AIM: This study aimed to evaluate the role preoperative chemo-radiotherapy with oral capacitabine for advanced low rectal cancer within 6 cm of anal verge. PATIENTS AND METHODS: Twenty-six patients with rectal adenocarcinoma were treated with preoperative radiotherapy, and oral capecitabine administrated at 5 days/week. Conventional abdominoperineal resection (APR) was done in 12 patients, and sphincter-saving resection (SSR) in 14 patients, the mean follow-up was 26.92+/-6.69 months. RESULTS: Oral capecitabine was well tolerated in all patients; grade 3 toxicity was seen in only one patient (3.85%) in the form of febrile neutropenia, and diarrhea. Clinical response observed in 17 patients (65.38%). There were no intra or postoperative deaths. Pathological down-staging was seen in 16 patients (61.53%) and pathological complete response in three patients (11.54%). There were two disease-linked deaths, one controlled regional recurrence, two evolutive patients (pulmonary metastases), and 22 disease-free patients. CONCLUSION: Preoperative chemo-radiotherapy with oral capecitabine induced significant down-staging. Combining such a regimen with intersphincteric resection led to the achievement of distal and radial negative margins, allowing a low local recurrence rate.
AIM: This study aimed to evaluate the role preoperative chemo-radiotherapy with oral capacitabine for advanced low rectal cancer within 6 cm of anal verge. PATIENTS AND METHODS: Twenty-six patients with rectal adenocarcinoma were treated with preoperative radiotherapy, and oral capecitabine administrated at 5 days/week. Conventional abdominoperineal resection (APR) was done in 12 patients, and sphincter-saving resection (SSR) in 14 patients, the mean follow-up was 26.92+/-6.69 months. RESULTS: Oral capecitabine was well tolerated in all patients; grade 3 toxicity was seen in only one patient (3.85%) in the form of febrile neutropenia, and diarrhea. Clinical response observed in 17 patients (65.38%). There were no intra or postoperative deaths. Pathological down-staging was seen in 16 patients (61.53%) and pathological complete response in three patients (11.54%). There were two disease-linked deaths, one controlled regional recurrence, two evolutive patients (pulmonary metastases), and 22 disease-free patients. CONCLUSION: Preoperative chemo-radiotherapy with oral capecitabine induced significant down-staging. Combining such a regimen with intersphincteric resection led to the achievement of distal and radial negative margins, allowing a low local recurrence rate.
Authors: P Piedbois; P Rougier; M Buyse; J Pignon; L Ryan; R Hansen; B Zee; B Weinerman; J Pater; C Leichman; J Macdonald; J Benedetti; J Lokich; J Fryer; G Brufman; R Isacson; A Laplanche; E Levy Journal: J Clin Oncol Date: 1998-01 Impact factor: 44.544
Authors: W Scheithauer; J McKendrick; S Begbie; M Borner; W I Burns; H A Burris; J Cassidy; D Jodrell; P Koralewski; E L Levine; N Marschner; J Maroun; P Garcia-Alfonso; J Tujakowski; G Van Hazel; A Wong; J Zaluski; C Twelves Journal: Ann Oncol Date: 2003-12 Impact factor: 32.976