Safety and efficacy of preoperative mFOLFOX6 regimen chemotherapy for locally resectable advanced rectal cancer.
10.11817/j.issn.1672-7347.2021.190256
- Author:
Libing LIU
1
;
Zhongjun JIANG
2
Author Information
1. Anorectal Department, Affiliated Nanhua Hospital, University of South China, Hengyang Hunan 421002. 492268285@qq.com.
2. Department of Thyroid and Breast Surgery, Affiliated Nanhua Hospital, University of South China, Hengyang Hunan 421002, China. 1601340054@qq.com.
- Publication Type:Journal Article
- Keywords:
downstage;
mFOLFOX6;
neoadjuvant chemotherapy;
rectal cancer;
resection
- MeSH:
Antineoplastic Combined Chemotherapy Protocols/adverse effects*;
China;
Fluorouracil/adverse effects*;
Humans;
Neoadjuvant Therapy;
Neoplasm Staging;
Prospective Studies;
Rectal Neoplasms/surgery*;
Treatment Outcome
- From:
Journal of Central South University(Medical Sciences)
2021;46(1):32-38
- CountryChina
- Language:English
-
Abstract:
OBJECTIVES:Neoadjuvant chemotherapy combined with radical surgery has become the treatment model for locally advanced rectal cancer. The purpose of this study was to evaluate the safety and efficacy of postoperative mFOLFOX6 regimen chemotherapy for locally resectable advanced rectal cancer.
METHODS:This was a prospective study. A total of 82 patients with locally advanced rectal cancer admitted to Affiliated Nanhua Hospital, University of South China from February 2015 to December 2017 were selected as the subjects. The patients received 4 courses of mFOLFOX6 chemotherapy and underwent surgery within 4-6 weeks after chemotherapy. The incidences of chemotherapy-related adverse reactions, postoperative complications, and clinical pathological reactions were analyzed.
RESULTS:In the period from mFOLFOX6 chemotherapy to preoperative, 82 patients with locally advanced rectal cancer was reported chemotherapy-related adverse reactions, including Grade 4 neutropenia (2.4%), catheter related infection (2.4%), and anorexia (2.4%), Grade 3 nausea (2.4%) and anorexia (2.4%), Grade 2 neutropenia (14.6%) and peripheral neuropathy (7.3%). Finally, 76 patients with locally advanced rectal cancer completed surgery, including 56 (73.7%) with anterior rectum resection, 16 (21.1%) with abdominal perineal resection, and 72 (94.7%) with pelvic nerve preservation. A total of 22 (28.9%) patients had surgical complications, including 8 (10.5%) with complications of Grade 3 or above. The complications with high incidence were intestinal obstruction, anastomotic leakage, and sepsis. Among the 76 patients who completed chemotherapy and surgery, T stage was decreased in 28 (36.8%) and N stage was decreased in 44 (57.9%); forty-two (55.3%) were in pathological Stage I, 20 (26.3%) in Stage IIA, 12 (15.8%) in Stage IIB, and 2 (2.6%) in Stage IIIA. Ten patients were suspected of tumor invasion of surrounding organs before chemotherapy, of which 4 patients did not need to extend the resection of surrounding organs after chemotherapy and achieved R0 resection of tumor; 2 in T
CONCLUSIONS:Preoperative mFOLFOX6 regimen chemotherapy for locally resectable advanced rectal cancer is a safe and feasible treatment strategy, and it is worthy of clinical application.
