Comparison of 5-fluorouracil/leucovorin and capecitabine in preoperative chemoradiotherapy for locally advanced rectal cancer

Journal Article · Thu Feb 01 04:00:00 EST 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2006.08.063· OSTI ID:20944676

Kim, Dae Yong ^[1]; Jung, Kyung Hae ^[1]; Kim, Tae Hyun ^[1]; Kim, Duck-Woo ^[1]; Chang, Hee Jin ^[1]; Jeong, Jun Yong ^[1]; Kim, Young Hoon ^[2]; Son, Seok-Hyun ^[3]; Yun, Tak ^[1]; Hong, Chang Won ^[1]; Sohn, Dae Kyung ^[1]; Lim, Seok-Byung ^[1]; Choi, Hyo Seong ^[1]; Jeong, Seung-Yong; Park, Jae-Gahb ^[1]

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1. Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)
2. Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of)
3. Department of Radiation Oncology, Kangnam St. Mary's Hospital, Seoul (Korea, Republic of)

Purpose: To describe our experience with a bolus injection of 5-fluorouracil and leucovorin (FL) vs. capecitabine in terms of radiologic and pathologic findings in preoperative chemoradiotherapy (CRT) for locally advanced rectal cancer. Methods: The study enrolled 278 patients scheduled for preoperative CRT using two protocols with different chemotherapeutic regimens. Pelvic radiotherapy (50.4 Gy) was delivered concurrently with FL (n = 145) or capecitabine (n = 133). Surgery was performed 6 weeks after CRT completion. Tumor responses to CRT were measured using both radiologic and pathologic examination. Magnetic resonance volumetry was performed at the initial workup and just before surgery after completion of preoperative CRT. Post-CRT pathology tests were used to determine tumor stage and regression. Results: Radiologic examination showed that tumor volume decreased by 68.2% {+-} 20.5% in the FL group and 68.3% {+-} 22.3% in the capecitabine group (p = 0.970). Postoperative pathologic T stage determination showed that downstaging occurred in 44.3% of FL and 49.9% of capecitabine patients (p = 0.571). The tumor regression grades after CRT were Grade 1 (minimal response) in 22.6% and 21.0%, Grade 2 (moderate response) in 53.2% and 50.0%, Grade 3 (near-complete response) in 12.9% and 12.9%, and Grade 4 (complete response) in 11.3% and 16.1% of the FL and capecitabine groups, respectively (p = 0.758). Conclusion: In the present study, the radiologic and pathologic findings did not reveal significant differences in short-term tumor responses between preoperative FL and capecitabine CRT for locally advanced rectal cancer. Long-term results and a prospective randomized trial are needed.

• OSTI ID: 20944676
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 67; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
CITROVORUM FACTOR
COMBINED THERAPY
MAGNETIC RESONANCE
PATHOLOGY
PATIENTS
RADIOTHERAPY
RECTUM
SURGERY
URACILS