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Preoperative radiochemotherapy in rectal cancer:: Long-term results of a phase II trial
Ist Teil von
International journal of radiation oncology, biology, physics, 2000-01, Vol.46 (2), p.323-327
Ort / Verlag
New York, NY: Elsevier Inc
Erscheinungsjahr
2000
Quelle
Elsevier Journal Backfiles on ScienceDirect (DFG Nationallizenzen)
Beschreibungen/Notizen
Purpose: To assess toxicity and long-term results of preoperative chemoradiotherapy in rectal cancer.
Methods and Materials: Between 1989 and 1997, as a phase II study, 66 patients with T
3 M
0 rectal cancer received preoperatively a 45 Gy dose pelvic radiotherapy (XRT) combined with two 5-day chemotherapy courses (CT) of 5-Fluorouracil (5-FU) and Leucovorin (LV) delivered the first and fifth week of XRT. For each CT course, LV:20 mg/m
2/d
1-d
5,. While the 5-FU dose was variable from 450 to 350 mg/m
2/d first course and 370 to 350 mg/m
2/d second course. Surgery was planned 3 weeks later.
Results: XRT-CT was stopped in 1 patient due to progressive disease. CT was stopped in 1 patient due to toxicity. Grades 2 and 3 diarrhea were observed in 8 and 3 patients, respectively. One patient died from acute diarrhea due to deviation from recommendations; 60 patients went to surgery. Among the 58 patients operated on for cure, 5 had an R
1-resection. After a 4.5-year median follow-up, the 5-year pelvic disease-free survival was 92% for the whole group and 96% in the R
0-resection group.
Conclusion: Preoperative combined XRT-5-FU-LV is feasible if optimal XRT and patients are carefully managed. The recommended 5-FU daily dose is 350 mg/m
2 for both CT courses. This approach is currently tested in a large EORTC phase III trial.