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Title: Capecitabine Initially Concomitant to Radiotherapy Then Perioperatively Administered in Locally Advanced Rectal Cancer

Purpose: To evaluate the impact of neoadjuvant capecitabine, concomitant to radiotherapy, followed by capecitabine monotherapy, in operable locally advanced rectal cancer (LARC) by measuring pathologic response and conservative surgery rate, toxicity profile, and disease-free survival (DFS). Methods and Materials: From October 2002 to July 2006, a total of 51 patients affected by LARC (T3-T4 or any node positive tumor), received capecitabine (825 mg/m{sup 2}, orally, twice daily continuously) concomitant to radiotherapy on the pelvis (50.4 Gy/ 28 fractions), followed by two cycles of capecitabine (1,250 mg/m{sup 2}, orally, twice daily, 14 days on 7 days off) up until 2 weeks before surgery. Tailored adjuvant systemic treatment was discussed according to pathologic stage. Results: Of 51 patients, (median age 61 years, range 38-82 years; 19 women and 32 men; ECOG performance status 0/1/2: 46/4/1), 50 were evaluable for response: 18% complete pathologic remission; 12% T-downstaging, and 30% N-downstaging. One patient died before surgery from mesenteric stroke. Grade 3 acute toxicities were 2% diarrhea, 8% dermatitis, 2% liver function test elevation, and 2% hand-foot syndrome. Sphincter preservation rates for tumors {<=}6 cm from the anal verge were 62% and 80% for the whole population. Median follow up was 43.0 months (range 0.8-68.6more » months). Five-years DFS was 85.4% (95% CI = 75.3-95.4%). Conclusions: Based on our study results, we conclude that this regimen is well tolerated and active and compares favorably with existing capecitabine-based approaches.« less
Authors:
 [1] ;  [2] ; ;  [3] ;  [4] ; ;  [5] ;  [6] ;  [7] ;  [2] ;  [3] ;  [8] ; ;  [2]
  1. Medical Care Unit, Department of Medicine, European Institute of Oncology, Milan (Italy), E-mail: maria.zampino@ieo.it
  2. Medical Care Unit, Department of Medicine, European Institute of Oncology, Milan (Italy)
  3. Radiotherapy Division, European Institute of Oncology, Milan (Italy)
  4. Epidemiology and Biostatistics Division, European Institute of Oncology, Milan (Italy)
  5. General Surgery Department, European Institute of Oncology, Milan (Italy)
  6. Radiology Division, European Institute of Oncology, Milan (Italy)
  7. Endoscopy Division, European Institute of Oncology, Milan (Italy)
  8. (Italy)
Publication Date:
OSTI Identifier:
21282042
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 75; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2008.11.002; PII: S0360-3016(08)03691-2; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; DERMATITIS; DIARRHEA; FEET; HANDS; LIVER; NEOPLASMS; PATIENTS; PELVIS; RADIOTHERAPY; RECTUM; SURGERY; TOXICITY