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Preoperative chemoradiotherapy with oral doxifluridine plus low-dose oral leucovorin in unresectable primary rectal cancer

Authors
 Jinsil Seong  ;  Jae Ho Cho  ;  Nam Kyu Kim  ;  Jin Sik Min  ;  Chang Ok Suh 
Citation
 INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, Vol.50(2) : 435-439, 2001 
Journal Title
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
ISSN
 0360-3016 
Issue Date
2001
MeSH
Adenocarcinoma/drug therapy* ; Adenocarcinoma/radiotherapy* ; Adenocarcinoma/surgery ; Administration, Oral ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Combined Modality Therapy ; Diarrhea/chemically induced ; Diarrhea/etiology ; Female ; Floxuridine/administration & dosage ; Floxuridine/adverse effects ; Humans ; Leucovorin/administration & dosage ; Leucovorin/adverse effects ; Male ; Middle Aged ; Preoperative Care ; Radiotherapy/adverse effects ; Rectal Neoplasms/drug therapy* ; Rectal Neoplasms/radiotherapy* ; Rectal Neoplasms/surgery ; Thrombocytopenia/chemically induced ; Thrombocytopenia/etiology
Keywords
Doxifluridine ; Chemoradiotherapy ; Unresectable rectal cancer
Abstract
PURPOSE:
The use of oral chemotherapeutic agents in chemoradiotherapy provides several advantages. Doxifluridine, an oral 5-FU prodrug, has been shown to be effective in colorectal cancer. We attempted a Phase II trial of preoperative chemoradiotherapy with doxifluridine plus a low-dose oral leucovorin in unresectable primary rectal cancer patients. In this study, toxicity and efficacy were evaluated.
METHODS AND MATERIALS:
There were 23 patients with primary unresectable rectal cancer in this trial, 21 of whom were available for analysis. The patients were treated with oral doxifluridine (900 mg/day) plus oral leucovorin (30 mg/day) from days 1 to 35, and pelvic radiation of 45 Gy over 5 weeks. Surgical resection was performed 5-6 weeks after the treatment.
RESULTS:
Acute toxicity involved thrombocytopenia, nausea/vomiting, diarrhea, and skin reaction. All were in Grade 1/2, except diarrhea, which was not only the most frequent (7 patients, 33.3%), but also the only toxicity of Grade 3 (2 patients). The clinical tumor response was shown in 5 patients (23.8%) as a complete response and 13 patients (61.9%) as a partial response. A complete resection with negative resection margin was done in 18 patients (85.7%), in 2 of whom a pathologic complete response was shown (9.5%). The overall downstaging rate in the T- and N-stage groupings was 71.4% (15 patients).
CONCLUSION:
This study demonstrated the efficacy and low toxicity of chemoradiotherapy with doxifluridine. Currently, a Phase III randomized trial of chemoradiotherapy is ongoing at our institute to compare the therapeutic efficacy of oral 5-FU with respect to i.v. 5-FU in locally advanced and unresectable rectal cancer.
Full Text
http://www.sciencedirect.com/science/article/pii/S0360301600015856?np=y
DOI
10.1016/S0360-3016(00)01585-6
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/142118
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