Shouki Bazarbashi1, Ayman Omar2, Ali Aljubran3, Ahmad Alzahrani3, Nasser Alsanea4, Alaa Abduljabbar4, Samar Alhomoud4, Luai Ashari4, Khalid Balaraj5, Hussein Soudy3, Mohammad Neimatallah6, Musa Fagih7. 1. Section of Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. Electronic address: bazarbashi@gmail.com. 2. Section of Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Department of Clinical Oncology and Nuclear Medicine (SCUCON), Suez Canal University Hospitals, Ismaileya, Egypt. 3. Section of Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. 4. Section of Colorectal Surgery, Department of Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. 5. Section of Radiation Oncology, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. 6. Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. 7. Section of Anatomic Pathology, Department of pathology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Abstract
BACKGROUND: Achieving a high rate of complete pathological response with pre-operative chemoradiotherapy in rectal cancer is an unmet need. We evaluated the efficacy and toxicity of the combination of cetuximab, capecitabine and radiation therapy in the pre-operative setting of localized rectal cancer. PATIENTS AND METHODS: Patients with clinically staged T3, T4 or nodepositive rectal cancer were treated with concurrent capecitabine and radiotherapy with weekly cetuximab starting one week before the start of radiation. This was followed by total mesorectal excision within 6-8 weeks. All patients achieving R0 resection received adjuvant capecitabine for 6 cycles. RESULTS: Fifteen patients were treated and all underwent surgery. Sphincter preservation was achieved in 11 patients (73.3%) and pathological complete response in two. With a median follow up of 48 months (range 8.4-57.5), 12 patients were relapse-free and 14 were alive with 4-year relapse free survival of 80%. Overall survival was 93%. Significant grade 3 and 4 toxicity was mainly cetuximab-induced skin reactions (33%), radiation-induced skin toxicity (13%) and diarrhea (20%). CONCLUSIONS: Adding cetuximab to pre-operative concurrent capecitabine and radiotherapy provides modest efficacy with manageable toxicity. Copyright Â
BACKGROUND: Achieving a high rate of complete pathological response with pre-operative chemoradiotherapy in rectal cancer is an unmet need. We evaluated the efficacy and toxicity of the combination of cetuximab, capecitabine and radiation therapy in the pre-operative setting of localized rectal cancer. PATIENTS AND METHODS: Patients with clinically staged T3, T4 or nodepositive rectal cancer were treated with concurrent capecitabine and radiotherapy with weekly cetuximab starting one week before the start of radiation. This was followed by total mesorectal excision within 6-8 weeks. All patients achieving R0 resection received adjuvant capecitabine for 6 cycles. RESULTS: Fifteen patients were treated and all underwent surgery. Sphincter preservation was achieved in 11 patients (73.3%) and pathological complete response in two. With a median follow up of 48 months (range 8.4-57.5), 12 patients were relapse-free and 14 were alive with 4-year relapse free survival of 80%. Overall survival was 93%. Significant grade 3 and 4 toxicity was mainly cetuximab-induced skin reactions (33%), radiation-induced skin toxicity (13%) and diarrhea (20%). CONCLUSIONS: Adding cetuximab to pre-operative concurrent capecitabine and radiotherapy provides modest efficacy with manageable toxicity. Copyright Â
Authors: Shouki Bazarbashi; Mahmoud A Elshenawy; Ahmed Badran; Ali Aljubran; Ahmed Alzahrani; Hadeel Almanea; Abdullah Alsuhaibani; Ahmed Alashwah; Mohamed Neimatallah; Alaa Abduljabbar; Luai Ashari; Samar Alhomoud; Hazem Ghebeh; Tusneem Elhassan; Nasser Alsanea; Mohammed Mohiuddin Journal: Cancer Med Date: 2022-02-10 Impact factor: 4.711