PURPOSE: The aim of our study was to evaluate the feasibility and the effectiveness of an intensified neoadjuvant protocol with the addition of weekly oxaliplatin in the preoperative strategy of rectal cancer treatment. PATIENTS AND METHODS: Patients with locally advanced rectal cancer received continous infusion 5-Fluorouracil (5-FU) 200 mg/m(2)/day in combination with weekly oxaliplatin at a dose of 50 mg/m(2). Doses of radiotherapy were 45 Gy to the whole pelvis plus 5.4-9 Gy to the tumour mass. The primary end-points of the study were evaluation of toxicity, compliance with radiotherapy and chemotherapy, downstaging, pathological complete response (pCR) and the rate of sphincter preservation for distal cancers. Secondary end-points were relapse-free and overall survival. RESULTS: From November 2006 to June 2009, 51 patients were enrolled into the study. Compliance with chemotherapy was 80%. The incidence of G3 diarrhoea and proctitis were 17.6% and 21.5%, respectively. Surgery was performed in 48 patients with 100% R0 resection. 76.4% of low-lying tumours underwent conservative treatment. Seventy-nine percent of patients were downstaged: T and N downstaging were observed in 71% and 75% of patients, respectively. A pCR was obtained in 11 (22.9%) patients. CONCLUSIONS: Intensification of neoadjuvant treatment for rectal cancer with the addition of weekly oxaliplatin is feasible, with remarkable rates of downstaging and pathological complete response. Data on sphincter preservation for distal cancers were excellent. Phase III trials with a longer follow-up will establish whether this good outcome in terms of surrogate end-points will translate into better rates of disease-free and overall survival.
PURPOSE: The aim of our study was to evaluate the feasibility and the effectiveness of an intensified neoadjuvant protocol with the addition of weekly oxaliplatin in the preoperative strategy of rectal cancer treatment. PATIENTS AND METHODS: Patients with locally advanced rectal cancer received continous infusion 5-Fluorouracil (5-FU) 200 mg/m(2)/day in combination with weekly oxaliplatin at a dose of 50 mg/m(2). Doses of radiotherapy were 45 Gy to the whole pelvis plus 5.4-9 Gy to the tumour mass. The primary end-points of the study were evaluation of toxicity, compliance with radiotherapy and chemotherapy, downstaging, pathological complete response (pCR) and the rate of sphincter preservation for distal cancers. Secondary end-points were relapse-free and overall survival. RESULTS: From November 2006 to June 2009, 51 patients were enrolled into the study. Compliance with chemotherapy was 80%. The incidence of G3 diarrhoea and proctitis were 17.6% and 21.5%, respectively. Surgery was performed in 48 patients with 100% R0 resection. 76.4% of low-lying tumours underwent conservative treatment. Seventy-nine percent of patients were downstaged: T and N downstaging were observed in 71% and 75% of patients, respectively. A pCR was obtained in 11 (22.9%) patients. CONCLUSIONS: Intensification of neoadjuvant treatment for rectal cancer with the addition of weekly oxaliplatin is feasible, with remarkable rates of downstaging and pathological complete response. Data on sphincter preservation for distal cancers were excellent. Phase III trials with a longer follow-up will establish whether this good outcome in terms of surrogate end-points will translate into better rates of disease-free and overall survival.
Authors: E Kapiteijn; C A Marijnen; I D Nagtegaal; H Putter; W H Steup; T Wiggers; H J Rutten; L Pahlman; B Glimelius; J H van Krieken; J W Leer; C J van de Velde Journal: N Engl J Med Date: 2001-08-30 Impact factor: 91.245
Authors: Magali Espinosa; Moises Martinez; José Luis Aguilar; Aída Mota; Jaime G De la Garza; Vilma Maldonado; Jorge Meléndez-Zajgla Journal: Cancer Chemother Pharmacol Date: 2004-10-21 Impact factor: 3.333
Authors: Carlo Capirci; Vincenzo Valentini; Luca Cionini; Antonino De Paoli; Claus Rodel; Robert Glynne-Jones; Claudio Coco; Mario Romano; Giovanna Mantello; Silvia Palazzi; Falchetti Osti Mattia; Maria Luisa Friso; Domenico Genovesi; Cristiana Vidali; Maria Antonietta Gambacorta; Alberto Buffoli; Marco Lupattelli; Maria Silvia Favretto; Giuseppe La Torre Journal: Int J Radiat Oncol Biol Phys Date: 2008-04-11 Impact factor: 7.038
Authors: Nam Kyu Kim; Seung Hyuk Baik; Jin Sil Seong; Hoguen Kim; Jae Kyung Roh; Kang Young Lee; Seung Kook Sohn; Chang Hwan Cho Journal: Ann Surg Date: 2006-12 Impact factor: 12.969
Authors: Krzysztof Bujko; Piotr Richter; Milena Kołodziejczyk; Marek P Nowacki; Jan Kulig; Tadeusz Popiela; Tomasz Gach; Janusz Oledzki; Rafał Sopyło; Wiktor Meissner; Ryszard Wierzbicki; Wojciech Polkowski; Teresa Kowalska; Grazyna Stryczyńska; Krzysztof Paprota Journal: Radiother Oncol Date: 2009-03-16 Impact factor: 6.280
Authors: G Lezoche; M Baldarelli; Mario Guerrieri; A M Paganini; A De Sanctis; S Bartolacci; E Lezoche Journal: Surg Endosc Date: 2007-10-18 Impact factor: 4.584