Induction chemotherapy, chemoradiotherapy and consolidation chemotherapy in preoperative treatment of rectal cancer - long-term results of phase II OIGIT-01 Trial

Autor: Irena Oblak, Ana Jeromen, Franc Anderluh, Ajra Secerov-Ermenc, Erik Brecelj, Jasna But-Hadzic, Vaneja Velenik, Ibrahim Edhemovic, Mirko Omejc, Danijela Golo
Rok vydání: 2018
Předmět:
Adult
Male
Antimetabolites
Antineoplastic
medicine.medical_specialty
Colorectal cancer
medicine.medical_treatment
Slovenia
R895-920
Urology
Capecitabine
pathologic complete response
Medical physics. Medical radiology. Nuclear medicine
03 medical and health sciences
0302 clinical medicine
Preoperative Care
medicine
Clinical endpoint
Humans
Radiology
Nuclear Medicine and imaging
030212 general & internal medicine
rectal cancer
total neoadjuvant therapy
Aged
Neoplasm Staging
Aged
80 and over
Rectal Neoplasms
business.industry
Induction chemotherapy
Consolidation Chemotherapy
Chemoradiotherapy
Induction Chemotherapy
Middle Aged
medicine.disease
Survival Rate
Radiation therapy
Oncology
030220 oncology & carcinogenesis
Concomitant
preoperative chemoradiotherapy
Female
business
Research Article
neoadjuvant chemotherapy
medicine.drug
Zdroj: Radiology and oncology (Ljubljana)
Radiology and Oncology, Vol 52, Iss 3, Pp 267-274 (2018)
Radiology and Oncology
ISSN: 1581-3207
DOI: 10.2478/raon-2018-0028
Popis: Background The purpose of the study was to improve treatment efficacy for locally advanced rectal cancer (LARC) by shifting half of adjuvant chemotherapy preoperatively to one induction and two consolidation cycles. Patients and methods Between October 2011 and April 2013, 66 patients with LARC were treated with one induction chemotherapy cycle followed by chemoradiotherapy (CRT), two consolidation cycles, surgery and three adjuvant capecitabine cycles. Radiation doses were 50.4 Gy for T2-3 and 54 Gy for T4 tumours in 1.8 Gy daily fraction. The doses of concomitant and neo/adjuvant capecitabine were 825 mg/m2/12h and 1250mg/m2/12h, respectively. The primary endpoint was pathologic complete response (pCR). Results Forty-three (65.1%) patients were treated according to protocol. The compliance rates for induction, consolidation, and adjuvant chemotherapy were 98.5%, 93.8% and 87.3%, respectively. CRT was completed by 65/66 patients, with G ≥ 3 non-hematologic toxicity at 13.6%. The rate of pCR (17.5%) was not increased, but N and the total-down staging rates were 77.7% and 79.3%, respectively. In a median follow-up of 55 months, we recorded one local relapse (LR) (1.6%). The 5-year disease-free survival (DFS) and overall survival (OS) rates were 64.0% (95% CI 63.89–64.11) and 69.5% (95% CI 69.39–69.61), respectively. Conclusions In LARC preoperative treatment intensification with capecitabine before and after radiotherapy is well tolerated, with a high compliance rate and acceptable toxicity. Though it does not improve the local effect, it achieves a high LR rate, DFS, and OS.
Databáze: OpenAIRE
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