J Korean Med Sci.  2006 Feb;21(1):52-57. 10.3346/jkms.2006.21.1.52.

Comparison of the Efficacy of Oral Capecitabine versus Bolus 5-FU in Preoperative Radiotherapy of Locally Advanced Rectal Cancer

• Kim JS
• Kim JS
• Cho MJ
• Yoon WH
• Song KS

• KMID: 2157782
• DOI: http://doi.org/10.3346/jkms.2006.21.1.52

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.

Keyword

Fluorouracil; capecitabine; Radiotherapy; drug therapy; Rectal Neoplasms

MeSH Terms

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

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