Fulltext

Simultaneous neoadjuvant radiochemotherapy with capecitabine and oxaliplatin for locally advanced rectal cancer : Treatment outcome outside clinical trials = Simultane neoadjuvante Radiochemotherapie mit Capecitabin und Oxaliplatin beim lokal fortgeschrittenen Rektumkarzinom : Therapieergebnisse außerhalb klinischer Studien

Winkler, J. ; Zipp, L. ; Knoblich, J. ; Zimmermann, F.

In: Strahlentherapie und Onkologie, 2012, vol. 188, no. 5, p. 377-382

Add to personal list
    Title
    • Simultaneous neoadjuvant radiochemotherapy with capecitabine and oxaliplatin for locally advanced rectal cancer
      Treatment outcome outside clinical trials
    Translated Title ()
    • Simultane neoadjuvante Radiochemotherapie mit Capecitabin und Oxaliplatin beim lokal fortgeschrittenen Rektumkarzinom
    Author
    • Winkler, J.. Department of Radiation Oncology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
    • Zipp, L.. Department of Radiation Oncology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
    • Knoblich, J.. Outpatient Oncology Centre, Lörrach, Germany
    • Zimmermann, F.. Department of Radiation Oncology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:313592
    Summary
    Background: Phase II trials of neoadjuvant treatment in UICC-TNM stageII and III rectal cancer with capecitabine and oxaliplatin demonstrated favourable rates on tumour regression with acceptable toxicity. Patients and methods: Retrospective evaluation of 34 patients treated from 2005-2008 outside clinical trials (CTR) with neoadjuvant irradiation (45-50.4Gy) and simultaneous capecitabine 825mg/m2 b.i.d. on days 1-14 and 22-35 and oxaliplatin 50mg/m2 on days 1, 8, 22 and 29 (CAPOX). Twenty-six (77%) patients received one or two courses of capecitabine 1,000mg/m2 b.i.d. on days 1-14 and oxaliplatin 130mg/m2 on day 1 (XELOX) prior to simultaneous chemoradiotherapy. Results: UICC-TNM stage regression was observed in 60% (n = 20). Dworak's regression grades 3 and 4 were achieved in 18.2% (n = 6) and 15.1% (n = 5) of the patients. Sphincter-preserving surgery was performed in 53% (n = 8) of patients with a tumour of the lower rectum. Within the mean observation of 24 months, none of the patients relapsed locally, 1patient had progressive disease and 5patients (15%) relapsed distantly. Toxicity of grade 3 and 4 was mainly diarrhoea 18% (n = 6) and perianal pain 9% (n = 3). Nevertheless, severe cardiac events (n = 2), severe electrolyte disturbances (n = 2), and syncopes (n = 2) were observed as well. Conclusion: Treatment efficacy and common toxicity are similar to the reports of phaseI/II trials. However, several severe adverse events were observed in our cohort study. The predisposing factors for these events have yet to be studied and may have implications for the selection of patients outside CTR