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Title: Preoperative Capecitabine and Pelvic Radiation in Locally Advanced Rectal Cancer-Is it Equivalent to 5-FU Infusion Plus Leucovorin and Radiotherapy?

Purpose: The aim of this retrospective case-matching study was to compare the treatment outcomes and acute toxicity of preoperative radiotherapy (RT) with capecitabine vs. preoperative RT with intermittent 5-fluorouracil (5-FU) infusion, leucovorin, and mitomycin C in rectal cancer. Methods and Materials: We matched 34 patients who were treated with preoperative concurrent capecitabine and 50 Gy of RT by their clinical T stage (T3 or T4) and the tumor location (<=7 cm or >7 cm from the anal verge) with another 68 patients who were treated with preoperative intermittent 5-FU infusion, leucovorin, mitomycin C, and 50 Gy of RT for a comparison of the pathologic tumor response, local control, distant failure, and survival rates. Results: The pathologic complete response rate was 21% with capecitabine and 18% with 5-FU and leucovorin (p = 0.72). The rate of T downstaging after chemoradiation was 59% for both groups. The rate of sphincter-sparing resection was 38% after capecitabine plus RT and 43% after 5-FU plus RT (p = 0.67). At 3 years, there was no significant difference in the local control rate (93% for capecitabine and 92% for 5-FU and leucovorin), relapse-free rate (74% for capecitabine and 73% for 5-FU and leucovorin), or disease-specific survivalmore » rate (86% for capecitabine and 77% for 5-FU and leucovorin). The acute toxicity profile was comparable, with little Grade 3 and 4 toxicity. Conclusions: When administered with concurrent preoperative RT, both capecitabine and intermittent 5-FU infusion with leucovorin modulation provided comparable pathologic tumor response, local control, relapse-free survival, and disease-specific survival rates in rectal cancer.« less
Authors:
 [1] ;  [2] ;  [3]
  1. Department of Radiation Oncology, Tom Baker Cancer Centre, Calgary, Alberta (Canada)
  2. Department of Medical Oncology, Tom Baker Cancer Centre, Calgary, Alberta (Canada)
  3. Department of Surgery, Tom Baker Cancer Centre, Calgary, Alberta (Canada)
Publication Date:
OSTI Identifier:
21372206
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 76; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2009.03.048; PII: S0360-3016(09)00517-3; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CITROVORUM FACTOR; FLUOROURACILS; INFUSION; MITOMYCIN; NEOPLASMS; RADIOTHERAPY; RECTUM; TOXICITY ANTIBIOTICS; ANTI-INFECTIVE AGENTS; ANTIMETABOLITES; ANTIMITOTIC DRUGS; ANTINEOPLASTIC DRUGS; AZINES; BODY; DIGESTIVE SYSTEM; DISEASES; DRUGS; GASTROINTESTINAL TRACT; HETEROCYCLIC COMPOUNDS; HYDROXY COMPOUNDS; INTAKE; INTESTINES; LARGE INTESTINE; MEDICINE; NUCLEAR MEDICINE; ORGANIC COMPOUNDS; ORGANIC FLUORINE COMPOUNDS; ORGANIC HALOGEN COMPOUNDS; ORGANIC NITROGEN COMPOUNDS; ORGANS; PYRIMIDINES; RADIOLOGY; THERAPY; URACILS