Abstract |
This study aimed to evaluate the feasibility and efficacy of neoadjuvant chemoradiotherapy intensified with irinotecan in patients with locally advanced rectal cancer. Eligible patients had nonmetastatic disease at a locally advanced stage that made R0 resection and sphincter preservation uncertain. They received preoperative radiation over 6 weeks to 45 Gy and boost of 5.4 Gy and concurrent continuous infusion 5-fluorouracil 250 mg m(-2) day(-1) and weekly irinotecan 40 mg m(-2). In all, 37 patients entered the study. T stage at baseline as determined by ultrasound was T2/T3/T4 in 2/19/16 patients; 31 patients had lymph node involvement. The predominant toxicity was diarrhoea (grade 3/4 in 10/2 patients). Haematologic toxicity and surgical complications were moderate. Among 36 patients undergoing surgery, 32 (89%) had R0 resection and 23 (64%) sphincter preservation. Pathologic complete response (pCR) was achieved in eight (22%) of 36 patients, and 10 patients (28%) had only microscopic residual disease. At 4 years, overall survival was 66%, disease-free survival 73%, local relapse rate 7%, and distant failure rate 24%. Extent of resection and postoperative nodal status were significant predictors of overall and disease-free survival. Intensified neoadjuvant chemoradiotherapy with irinotecan can be safely administered and results in a high pCR rate.
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Authors | G Klautke, P Feyerherd, K Ludwig, F Prall, T Foitzik, R Fietkau |
Journal | British journal of cancer
(Br J Cancer)
Vol. 92
Issue 7
Pg. 1215-20
(Apr 11 2005)
ISSN: 0007-0920 [Print] England |
PMID | 15785742
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Irinotecan
- Fluorouracil
- Camptothecin
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Topics |
- Adenocarcinoma
(drug therapy, pathology, radiotherapy, surgery)
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Camptothecin
(administration & dosage, analogs & derivatives)
- Combined Modality Therapy
- Dose Fractionation, Radiation
- Female
- Fluorouracil
(administration & dosage)
- Humans
- Irinotecan
- Male
- Middle Aged
- Neoadjuvant Therapy
- Rectal Neoplasms
(drug therapy, pathology, radiotherapy, surgery)
- Survival Analysis
- Treatment Outcome
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