Preoperative chemoradiation with oxaliplatin and 5-fluorouracil in locally advanced rectal carcinoma

Alonso, Vicente; Salud, A.; Escudero, P.; Valencia, Javier; Mira, M.; Lobera, A. Ruiz de; Lambea, J.; Grandez, R.; Trés, A.; Antón, A.

doi:10.1200/jco.2004.22.14_suppl.3607

Cited by 4 publications

(3 citation statements)

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“…However, the rate of grade III/IV toxicity (10%) noted in this study is comparable with that reported for oxaliplatin regimes (18 -30%) (Alonso et al, 2004(Alonso et al, , 2007Casado et al, 2004;Tucci et al, 2004;Fakih et al, 2005;Machiels et al, 2005;Avallone et al, 2006;Rutten et al, 2006;Rödel et al, 2007). Indeed, the findings of this study suggest a safety profile for irinotecan, 5-FU and radiotherapy that is comparable with previously reported findings with capecitabine and radiotherapy (rate of grade III/IV diarrhoea 12 -28%) (Mehta et al, 2003;Navarro et al, 2003;Mitchell et al, 2004;Mohiuddin et al, 2006;Willeke et al, 2007), but using a lower radiation dose (45 Gy as opposed to 50.4 Gy in the capecitabine regimen).…”

Section: Discussionsupporting

confidence: 87%

Irinotecan+5-fluorouracil with concomitant pre-operative radiotherapy in locally advanced non-resectable rectal cancer: a phase I/II study

et al. 2008

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In the UK, 10% of patients diagnosed with rectal cancer have inoperable disease at presentation. This study ascertained whether the resectability rate of inoperable locally advanced rectal cancer was improved by administration of intravenous irinotecan, 5-fluorouracil (5-FU) and pelvic radiotherapy. During phase I of the trial (n ¼ 12), the dose of irinotecan was escalated in three-patient cohorts from 50 mg m À2 to 60 mg m À2 to 70 mg m À2 to identify the maximum tolerated dose (60 mg m À2 ). In phase II, 31 patients with nonresectable disease received 45 Gy radiotherapy and 5-FU infusions (200 mg m À2 per day) for 5 weeks. Irinotecan (60 mg m À2 ) was given on days 1, 8, 15 and 22. After treatment, patients were operated on if possible. Thirty patients completed the protocol, 28 underwent surgery. Before surgery, MRI restaging of 24 patients showed that 19 (79%) had a reduction in tumour stage after treatment (seven complete clinical response and 12 partial). Of 27 patients followed up after surgery, 22 (81%) had clear circumferential resection margins. Disease-free and overall survival estimates at 3 years were 65 and 90%, respectively. The regimen was well tolerated. Irinotecan, 5-FU and radiotherapy results in tumour downgrading, allowing resection of previously inoperable tumour with acceptable toxicity.

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Section: Discussionsupporting

confidence: 87%

Irinotecan+5-fluorouracil with concomitant pre-operative radiotherapy in locally advanced non-resectable rectal cancer: a phase I/II study

et al. 2008

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“…In the present work, the rate of pCR recorded in the oxaliplatin group was greater than that observed in other similar phase I-II studies 22,23 , and again this could be related to the small number of patients examined. When ypT0-ypT1 stages were compared together, P = 0.051, which is close to statistical significance.…”

Section: Discussioncontrasting

confidence: 79%

Comparison between Intensified Neoadjuvant Treatment and Standard Preoperative Chemoradiation for Rectal Cancer

Musio

Raffetto

Dionisi

et al. 2010

Tumori

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Our data seem to correlate the addition of oxaliplatin to the standard treatment for rectal cancer with higher rates of sphincter preservation, down-staging and complete response. Toxicity is increased and requires careful monitoring. However, our results refer to a retrospective comparison of a small series of patients and need to be validated by the large, phase III randomized trial currently ongoing.

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“…Several phase I ⁄ II trials have examined oxaliplatin plus a fluoropyrimidine as radiation sensitizers in rectal cancer CRT [89][90][91][92][93][94][95][96][97][98][99][100][101] (Table 2). Response rates in terms of pCR appear to be increased compared with historical reports using a single agent fluoropyrimidine.…”

Section: Oxaliplatin ⁄ Fluoropyrimidine Doubletsmentioning

confidence: 99%

Radiation, chemotherapy and biological therapy in the curative treatment of locally advanced rectal cancer

Gollins

2010

Colorectal Disease

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Preoperative chemoradiation with oxaliplatin and 5-fluorouracil in locally advanced rectal carcinoma

Cited by 4 publications

References 0 publications

Irinotecan+5-fluorouracil with concomitant pre-operative radiotherapy in locally advanced non-resectable rectal cancer: a phase I/II study

Irinotecan+5-fluorouracil with concomitant pre-operative radiotherapy in locally advanced non-resectable rectal cancer: a phase I/II study

Comparison between Intensified Neoadjuvant Treatment and Standard Preoperative Chemoradiation for Rectal Cancer

Radiation, chemotherapy and biological therapy in the curative treatment of locally advanced rectal cancer

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