Capecitabine as a Radiosensitizing Agent in Neoadjuvant Treatment of Locally Advanced Resectable Rectal Cancer: Prospective Phase II Trial

Velenik, Vaneja; Anderluh, Franc; Oblak, Irena; Strojan, Primož; Zakotnik, Branko
October 2006
Croatian Medical Journal;2006, Vol. 47 Issue 5, p693
Academic Journal
Aim To evaluate the efficacy and toxicity of preoperative chemoradiotherapy with capecitabine in locally advanced rectal cancer. Methods Between June 2004 and January 2005, 57 patients with operable, clinical stage II-III adenocarcinoma of the rectum entered the prospective phase II study. Radiation dose was 45 Gy (25 x 1.8 Gy). Concurrent chemotherapy with a daily dose of 1650 mg/m² capecitabine was administered orally, divided into two equal doses per day, including weekends. Patients were evaluated weekly for acute toxicity and compliance with the protocol. Surgery was scheduled 6 weeks after the completion of the chemoradiotherapy. Results A single female patient died after receiving 27 Gy, because of pulmonary embolism. All other patients completed the preoperative chemoradiotherapy according to the protocol and a definitive operation was performed in all but one of these patients. The complete pathological response was recorded in 5 patients (9.1%). Tumor (T), lymph nodes (N), and overall downstaging rates were 40%, 52.9%, and 49.1%, respectively. Total sphincter preservation rate was 65.5% (36 out of 55 patients) and the rate in 27 patients with tumors located within 5 cm of the anal opening was 37% (10 out of 27 patients). The most frequent side-effect of the combined therapy was dermatitis (grade 3 in 19 patients). After surgery, a single patient died due to sepsis during the early perioperative period. Nonlethal perioperative complications were recorded in 24/55 patients. Conclusion Preoperative chemoradiotherapy with oral capecitabine is safe and well tolerated. It has a downstaging potential and can increase the possibility for sphincter preservation surgery.


Related Articles

  • Neoadjuvant radiation and chemotherapy in rectal cancer does not increase postoperative complications. Valero, G.; Luján, J. A.; De las Heras, M.; Pellicer, E.; Serrano, A.; Parrilla, P.; Hernández, Q. // International Journal of Colorectal Disease;Nov2003, Vol. 18 Issue 6, p495 

    Background and aims. Neoadjuvant radiation and chemotherapy in rectal cancer reduces local recurrences and increases the rate of conservative sphincter surgery. However, an increase in postoperative morbidity and mortality has also been observed. This study analyzed the operative difficulty and...

  • Peritoneal Echinococcosis: Anatomoclinical Features and Surgical Treatment. Majbar, Mohammed; Souadka, Amine; Sabbah, Farid; Raiss, Mohamed; Hrora, Abdelmalek; Ahallat, Mohamed // World Journal of Surgery;May2012, Vol. 36 Issue 5, p1030 

    Background: Peritoneal hydatid disease is a rare and poorly known disease. We report our experience with 17 patients treated for peritoneal echinococcosis. The main objectives were to analyze and discuss the specific features of the anatomic peritoneal lesions along with their surgical...

  • Current Thoughts on the Surgical Treatment of Rectal Cancer. Golfmatis, B. C.; Delikaris, P. C.; Haritopoulos, N. K.; Setakis, N. G. // American Journal of Gastroenterology;Jan1976, Vol. 65 Issue 1, p68 

    From August, 1971 to May, 1974, 52 cases of rectal cancer belonging to different groups, according to Mason's classification, were seen at the First Surgical Department, University of Athens Medical School. In the majority of the eases the tumor was removed by combined abdomino-perineal...

  • Citations and Clinicians' Notes: Treatment/ Preoperative.  // Current Medical Literature: Colorectal Cancer;2003, Vol. 7 Issue 4, p102 

    Presents a commentary on the study "Detrimental Immunologic Effects of Preoperative Chemoradiotheraphy in Advanced Rectal Cancer." Examination of how the use of preoperative chemoradiation in Great Britain influences the preoperative pattern of immune parameters; Analysis of the effects of...

  • Clinical predictive factors of pathologic tumor response after preoperative chemoradiotherapy in rectal cancer. Chi Hwan Choi; Won Dong Kim; Sang Jeon Lee; Woo-Yoon Park // Radiation Oncology Journal;Sep2012, Vol. 30 Issue 3, p99 

    Purpose: The aim of this study was to identify clinical predictive factors for tumor response after preoperative chemoradiotherapy (CRT) in rectal cancer. Materials and Methods: The study involved 51 patients who underwent preoperative CRT followed by surgery between January 2005 and February...

  • Sphincter-Preserving Operations Following Preoperative Chemoradiation: An Alternative to Abdominoperineal Resection for Lower Rectal Cancer? Jung Wook Huh; Eun Joo Jung; Yoon Ah Park; Kang Young Lee; Seung-Kook Sohn // World Journal of Surgery;Jun2008, Vol. 32 Issue 6, p1116 

    Sphincter-preserving operations (SPO) for lower rectal cancer are on the rise. In the study reported here, we compared the oncologic outcomes of patients who underwent sphincter-preserving operations following preoperative chemoradiation for lower rectal cancer with the outcome for patients who...

  • Preoperative bi-fractionated accelerated radiation therapy for combined treatment of locally advanced rectal cancer in a consectutive series of unselected patients. Biffi, Roberto; Marsiglia, Hugo; Fossa, Barbara Jereczek; Leonardi, Maria Cristina; Cante, Domenico; Lazzari, Roberta; Chiappa, Antonio; Cenciarelli, Sabine; Andreoni, Bruno; Zampino, Maria Giulia; Orecchia, Roberto // International Seminars in Surgical Oncology;2007, Vol. 4, p23 

    Background: although preoperative RT (Radiation Therapy) is becoming the preferred approach for combined treatment of locally advanced rectal adenocarcinoma, no regimen can be now considered as a standard. Since the toxicity of preoperative RT isn't yet completely known, and the advantages of...

  • Phase I/II study of weekly irinotecan and concurrent radiation therapy for locally advanced non-small cell lung cancer. Takeda, K; Negoro, S; Kudoh, S; Okishio, K; Masuda, N; Takada, M; Tanaka, M; Nakajima, T; Tada, T // British Journal of Cancer;3/15/99, Vol. 79 Issue 9/10, p1462 

    A study was undertaken to determine the maximum tolerated dose, the dose-limiting toxicities, and the response rate of irinotecan administered weekly with concurrent thoracic radiation therapy in patients with locally advanced non-small-cell lung cancer. In a phase I/II clinical trial, patients...

  • Preoperative chemoradiation for rectal cancer: kudos and a caution. Kendal, Wayne S.; Stern, Hartley S. // Canadian Journal of Surgery;Apr2004, Vol. 47 Issue 2, p87 

    Analyzes the role of preoperative chemoradiation in the management of rectal cancer. Benefits of surgical management of patients with rectal cancer; Issue of potential salvage rate for recurrent cancer after an initial clinical complete response; Dose of multiple daily fractions for a period of...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics