Comparison of the Efficacy of Oral Capecitabine versus Bolus 5-FU in Preoperative Radiotherapy of Locally Advanced Rectal Cancer.
10.3346/jkms.2006.21.1.52
- Author:
Jae Sung KIM
1
;
Jun Sang KIM
;
Moon June CHO
;
Wan Hee YOON
;
Kye Sang SONG
Author Information
1. Department of Radiation Oncology, College of Medicine, Seoul National University, Seoul, Korea.
- Publication Type:Original Article ; Clinical Trial ; Comparative Study
- Keywords:
Fluorouracil;
capecitabine;
Radiotherapy;
drug therapy;
Rectal Neoplasms
- MeSH:
Administration, Oral;
Adult;
Aged;
Antimetabolites, Antineoplastic/administration & dosage/adverse effects/therapeutic use;
Combined Modality Therapy;
Comparative Study;
Deoxycytidine/administration & dosage/adverse effects/*analogs & derivatives/therapeutic use;
Diarrhea/chemically induced;
Drug Administration Schedule;
Fatigue/chemically induced;
Female;
Fluorouracil/administration & dosage/adverse effects/*therapeutic use;
Humans;
Leukopenia/chemically induced;
Male;
Middle Aged;
Neoplasm Staging;
Postoperative Complications/therapy;
Rectal Neoplasms/*drug therapy/radiotherapy/surgery;
Retrospective Studies;
Treatment Outcome
- From:Journal of Korean Medical Science
2006;21(1):52-57
- CountryRepublic of Korea
- Language:English
-
Abstract:
The effects of treatment with oral capecitabine vs. bolus 5-FU, administered concurrently with preoperative radiotherapy, were compared in the treatment of locally advanced rectal cancer (LARC). One hundred and twenty-seven patients with LARC received concurrent preoperative chemoradiation using two cycles bolus 5-FU (500 mg/m2/day) plus leucovorin (LV, 20 mg/m2/day) (Group I). Another LARC group received concurrent chemoradiation using two cycles 1,650 mg/m2/day of oral capecitabine and 20 mg/m2/day of LV (Group II, 97 patients). Radiation was delivered to the primary tumor at 50.4 Gy in both groups. Definitive surgery was performed 6 weeks after the completion of chemoradiation. A pathologic complete remission was achieved in 11.4% of patients in Group I and in 22.2% of patients in Group II (p= 0.042). The down-staging rates of the primary tumor and lymph nodes were 39.0/ 68.7% in Group I and 61.1/87.5% in Group II (p=0.002/0.005). Sphincter-preserving surgery was possible in 42.1% of patients in Group I and 66.7% of those in Group II (p=0.021). Grade 3 or 4 leucopenia, diarrhea, and radiation dermatitis were statistically more prevalent in Group I than in Group II, while the opposite was true for grade 3 hand-foot syndrome. Preoperative chemoradiation using oral capecitabine was better tolerated than bolus 5-FU and was more effective in the promotion of both down-staging and sphincter preservation in patients with LARC.
