Neoadjuvant chemotherapy with or without oxaliplatin after short-course radiotherapy in high-risk rectal cancer: A subgroup analysis from a prospective study
| Autor: | Krzysztof Bujko, Andrzej Rutkowski, Lucyna Pietrzak, Marek Szczepkowski, Lucjan Wyrwicz, Wojciech Polkowski, Wojciech Michalski, Roman Styliński, Jacek Krynski, Jacek Zwolinski, Bogumiła Ciseł, G. Nawrocki, Malgorzata Jankiewicz, Wiesław Tarnowski, Lucyna Kepka, Rafał Sopyło, Ewa Kosakowska |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
business.industry Colorectal cancer Hazard ratio Consolidation Chemotherapy Subgroup analysis medicine.disease Gastroenterology 030218 nuclear medicine & medical imaging Oxaliplatin 03 medical and health sciences 0302 clinical medicine Oncology 030220 oncology & carcinogenesis Internal medicine Medicine Radiology Nuclear Medicine and imaging Cumulative incidence Original Research Article Radical surgery business Prospective cohort study medicine.drug |
| Zdroj: | Rep Pract Oncol Radiother |
| ISSN: | 1507-1367 |
| DOI: | 10.1016/j.rpor.2020.08.002 |
| Popis: | Aim To evaluate the role of oxaliplatin in neoadjuvant chemotherapy delivered after short-course irradiation. Background Using oxaliplatin in the above setting is uncertain. Patients and methods A subgroup of 136 patients managed by short-course radiotherapy and 3 cycles of consolidation chemotherapy within the framework of a randomised study was included in this post-hoc analysis. Sixty-seven patients received FOLFOX4 (oxaliplatin group) while oxaliplatin was omitted in the second period of accrual in 69 patients because of protocol amendment (fluorouracil-only group). Results Grade 3+ acute toxicity from neoadjuvant treatment was observed in 30% of patients in the oxaliplatin group vs. 16% in the fluorouracil-only group (p = 0.053). The corresponding proportions of patients having radical surgery or achieving complete pathological response were 72% vs. 77% (odds ratio [OR] = 0.88; 95% confidence interval [CI]: 0.39–1.98; p = 0.75) and 15% vs. 7% (OR = 2.25; 95% CI: 0.83–6.94; p = 0.16), respectively. The long-term outcomes were similar in the two groups. Overall and disease-free survival rates at 5 years were 63% vs. 56% (p = 0.78) and 49% vs. 44% (p = 0.59), respectively. The corresponding numbers for cumulative incidence of local failure or distant metastases were 33% vs. 38% (hazard ratio [HR] = 0.89; 95% CI: 0.52–1.52; p = 0.68) and 33% vs. 33% (HR = 0.78; 95% CI: 0.43–1.40; p = 0.41), respectively. Conclusion Our findings do not support adding oxaliplatin to three cycles of chemotherapy delivered after short-course irradiation. |
| Databáze: | OpenAIRE |
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