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Preoperative chemoradiation with oral tegafur within a multidisciplinary therapeutic approach in patients with T3-4 rectal cancer.

AbstractPURPOSE:
The aim of this study was to evaluate the activity in terms of downstaging histologic patterns of residual tumor and clinical tolerance of a neoadjuvant chemoradiation program with oral tegafur for rectal cancer.
METHODS AND MATERIALS:
From May 1998 to May 2001, 62 consecutive patients with cT(3-4) or cN(+) rectal cancer, or both, were treated with 45-50 Gy (1.8 Gy/day; 25 fractions) and oral tegafur 1200 mg/day. Surgery was performed 6 weeks after the completion of chemoradiation. All patients received a boost with intraoperative electron beam radiotherapy (IOERT) over the presacral space.
RESULTS:
Grade 3-4 hematologic toxicity consisted on Grade 3 anemia in 1 patient. Nonhematologic toxicity was mild. Fifteen patients (23%) had Grade 3 dermatitis, 16 (25%) had Grade 3, and 2 (3%) had Grade 4 proctitis. The median dose of radiotherapy was 50.4 Gy. Surgery consisted on anterior resection in 38 patients (61%) and abdominoperineal amputation in 24 (39%). Five complete pathologic responses were observed (8%), and 29 patients (47%) had a minimal microscopic residual tumor (mic category). The total downstaging rate was 68%. With a median follow-up of 46 months, the pelvic control rate was 95%, disease-free survival 74.1%, and overall survival 76.5%.
CONCLUSIONS:
Neoadjuvant chemoradiation with oral tegafur is feasible, well tolerated, and active, with the additional advantage of offering the convenience of oral chemotherapy.
AuthorsJuan A Díaz-González, Felipe A Calvo, Javier Cortés, Dolores de La Mata, Marina Gómez-Espí, Miguel A Lozano, Esperanza Lozano, Javier Serrano, Rafael Herranz
JournalInternational journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 61 Issue 5 Pg. 1378-84 (Apr 01 2005) ISSN: 0360-3016 [Print] United States
PMID15817340 (Publication Type: Journal Article)
Chemical References
  • Antineoplastic Agents
  • Tegafur
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents (therapeutic use)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoadjuvant Therapy (adverse effects, methods)
  • Neoplasm Staging
  • Radiotherapy Dosage
  • Rectal Neoplasms (drug therapy, pathology, radiotherapy, surgery)
  • Survival Analysis
  • Tegafur (therapeutic use)

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