A observational study of the efficacy and safety of capecitabine versus bolus infusional 5-fluorouracil in pre-operative chemoradiotherapy for locally advanced rectal cancer

Background and objectives This study is to evaluate the safety and efficacy of preoperative radiotherapy (RT) combined with bolus infusional 5-fluorouracil (5-FU) or oral capecitabine in patients with locally advanced rectal cancer (LARC). Materials and methods Seventy-four patients were retrospecti...

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Bibliographic Details
Published in:International journal of colorectal disease 2012-06, Vol.27 (6), p.727-736
Main Authors: Chen, Chin-Fan, Huang, Ming-Yii, Huang, Chih-Jen, Wu, Chan-Han, Yeh, Yung-Sung, Tsai, Hsiang-Lin, Ma, Cheng-Jen, Lu, Chien-Yu, Chang, Shun-Jen, Chen, Ming-Jenn, Wang, Jaw-Yuan
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Analysis
Antineoplastic Agents - administration & dosage
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Capecitabine
Care and treatment
Chemoradiotherapy - adverse effects
Colorectal cancer
Deoxycytidine - adverse effects
Deoxycytidine - analogs & derivatives
Deoxycytidine - therapeutic use
Female
Fluorouracil
Fluorouracil - administration & dosage
Fluorouracil - adverse effects
Fluorouracil - analogs & derivatives
Fluorouracil - therapeutic use
Gastroenterology
Hepatology
Humans
Infusions, Intravenous
Internal Medicine
Leucovorin
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Staging
Original Article
Preoperative Care
Proctology
Rectal Neoplasms - mortality
Rectal Neoplasms - pathology
Rectal Neoplasms - surgery
Rectal Neoplasms - therapy
Surgery
Treatment Outcome
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Summary:Background and objectives This study is to evaluate the safety and efficacy of preoperative radiotherapy (RT) combined with bolus infusional 5-fluorouracil (5-FU) or oral capecitabine in patients with locally advanced rectal cancer (LARC). Materials and methods Seventy-four patients were retrospectively analyzed. Twenty-seven patients were treated with 5-FU (350 mg/m 2 IV bolus) and leucovorin (20 mg/m 2 IV bolus) for 5 days/week during week 1 and 5 of RT. Forty-seven patients were treated with capecitabine (850 mg/m 2 , twice daily for 5 days/week). Both groups received the same RT course (45–50.4 Gy/25 fractions, 5 days/week, for 5 weeks). Patients underwent surgery in 6 weeks after completion of the chemoradiotherapy. Data of the observational study were collected. Results Grade 3 or 4 toxicities occurred in 40.7% (5-FU) and 19.1% (capecitabine) of the patients ( P  = 0.044). Six patients in the 5-FU group (22.2%) and six patients in the capecitabine group (14%) achieved complete response. Primary tumor (T) downstaging were achieved in 51.9% (5-FU) and 69.8% (capecitabine) of the patients. The pathological ypT0-2 stage was 40.7% (5-FU) and 67.4% (capecitabine) ( P  = 0.028). Conclusions In consideration of the better ypT0-2 downstaging rate, less severe toxicities, and no need for indwelling intravenous device on oral capecitabine regimen, the administration of oral capecitabine with RT may be a more favorable option in the neoadjuvant treatment for LARC.
ISSN:0179-1958
1432-1262
DOI:10.1007/s00384-011-1377-3