Pre-operative chemoradiotherapy with oral tegafur-uracil and leucovorin for rectal cancer.

Abstract:

BACKGROUND:To evaluate the efficacy and toxicity of pre-operative radiotherapy (RT) combined with oral tegafur-uracil (UFUR) plus leucovorin (LV) in rectal cancer. PATIENTS:Sixty-five patients with rectal adenocarcinoma (clinical staged T2-4N0-2M0) received pelvic RT of 45 Gy in 20 fractions over 28 days. Concurrent chemotherapy consisted of UFUR (200 mg/m(2)/day) and LV (45 mg/day) on day 1-28. UFUR (250 mg/m(2)/day) and LV were continued on day 36-63. Surgery was performed on day 70. RESULTS:Sixty-three patients completed the concurrent chemoradiotherapy (CCRT) and 56 received curative or palliative surgery. Among the 52 patients receiving curative resection, downstaging (DS) occurred in 39 (75%), pathological complete response in 13 (25%), and sphincter preservation was achieved in 16 of 29 (55%) with lower-seated tumors. With a median follow-up time of 33 months, local failure developed in 4 (8%) and distant metastases occurred in 7 (14%). The 3-year overall survival was 92% and disease-free survival 76%. For all 65 patients, grade 3-4 diarrhea developed in 6 (9%) and grade 3-4 leucopenia observed in 2 (3%). CONCLUSIONS:Oral UFUR + LV administered with pre-operative RT are effective in tumor DS, pathological complete response, and sphincter preservation with tolerable toxicity in rectal cancer.

journal_name

J Surg Oncol

authors

Wang LW,Yang SH,Lin JK,Lin TC,Chan WK,Chen WS,Wang HS,Jiang JK,Lee RC,Li AF,Chao Y,Chi KH,Yen SH

doi

10.1002/jso.20168

subject

Has Abstract

pub_date

2005-03-15 00:00:00

pages

256-63; discussion 263-4

issue

4

eissn

0022-4790

issn

1096-9098

journal_volume

89

pub_type

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