133 Acute Side Effects of Capecitabine Compared to 5fu for Concurrent Chemoradiation of Rectal Cancer: A 5-Year Review

Haddad, Peiman; Dadpour, Mehdi; Yari, Hadi; Farsiani, Amir Reza; Aghgili, M.; Amouzegar‐Hashemi, Farnaz; Esmati, Ebrahim; Farhan, Farshid; Kalaghchi, Bita; Kazemian, Ali; Samiei, Fatemeh

doi:10.1016/s0167-8140(12)72520-3

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“…So, the question is why short-course chemoradiation has produced such a good result. There are several reasons that could explain the more favorable results in this study; firstly, the precise delineation of target volumes based on international guidelines [14] and the strict confirmation of treatment plans, considering the sufficient coverage of PTV and also the dose of organs-at-risk; second, administration of capecitabine with radiotherapy instead of bolus 5FU is shown to be associated with fewer toxicities and higher response rates in a study by Haddad et al [30]; third, prolonging the interval between radiotherapy completion and surgery to more than 8 weeks, as this has been demonstrated by Rega et al [31] to reduce adverse events and increase response to neoadjuvant therapy. In our study, the interval from end of radiotherapy to surgery was higher compared with the majority of other similar studies.…”

Section: Discussionmentioning

confidence: 86%

Short-course versus long-course neoadjuvant chemoradiotherapy in patients with rectal cancer: preliminary results of a randomized controlled trial

et al. 2020

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Colorectal cancer is becoming an increasing concern in the middle-aged population of Iran. This study aimed to compare the preliminary results of short-course and long-course neoadjuvant chemoradiotherapy treatment for rectal cancer patients. Materials and Methods: In this clinical trial we recruited patients with rectal adenocarcinoma located from 5 cm to 15 cm above the anal verge. Patients in group I (short-course) received three-dimensional conformational radiotherapy with a dose of 25 Gy/5 fractions in 1 week plus concurrent XELOX regimen (capecitabine 625 mg/m 2 from day 1-5 twice daily and oxaliplatin 50 mg/m 2 on day 1 once daily). Patients in group II (long-course) received a total dose of 50-50.4 Gy/25-28 fractions for 5 to 5.5 weeks plus capecitabine 825 mg/m 2 twice daily. Both groups underwent consolidation chemotherapy followed by delayed surgery at least 8 weeks after radiotherapy completion. The pathological response was assessed with tumor regression grade. Results: In this preliminary report on complications and pathological response, 66 patients were randomized into two study groups. Mean duration of radiotherapy in the group II (long-course) was 5 ± 1 days (range, 5 to 8 days) and 38 ± 6 days (range, 30 to 58 days). The median follow-up was 18 months. Pathological complete response was achieved in 32.3% and 23.1% of patients in the shortcourse and long-course groups, respectively (p = 0.558). Overall, acute grade 3 or higher treatment-related toxicities occurred in 24.2% and 22.2% of patients in group I and II, respectively (p = 0.551). No acute grade 4 or 5 adverse events were observed in either group except one grade 4 hematologic toxicity that was seen in group II. Within one month of surgery, no significant difference was seen regarding grade ≥3 postoperative complications (p = 0.333). Conclusion: For patients with rectal cancer located at least 5 cm above the anal verge, short-course radiotherapy with concurrent and consolidation chemotherapy and delayed surgery is not different in terms of acute toxicity, postoperative morbidity, complete resection, and pathological response compared to long-course chemoradiotherapy.

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Section: Discussionmentioning

confidence: 86%