Cancer Res Treat.  2006 Feb;38(1):30-34.

Optimal Timing for the Administration of Capecitabine with Preoperative Chemoradiation for Locally Advanced Rectal Cancer

Affiliations
  • 1Department of Radiation Oncology, Ulsan University Hospital, Seoul, Korea.
  • 2Departments of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jhkim2@amc. seoul.kr
  • 3Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 4Department of Medical Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

PURPOSE
Capecitabine is an oral fluoropyrimidine carbamate and it is known as an effective radiosensitizer. Capecitabine and its metabolite reach their peak concentration in the plasma at 1~2 hours after a single oral administration of capecitabine and the levels fall rapidly thereafter. To verify the radiosensitizing effect of capecitabine that is based on such pharmacokinetic characteristics, we performed a retrospective analysis on the optimal timing of capecitabine administration with performing preoperative chemoradiation for locally advanced rectal cancer.
MATERIALS AND METHODS
Among 171 patients who were treated with preoperative radiotherapy and concurrent capecitabine administration for rectal cancer, 56 patients were administered capecitabine at 1~2 hours before radiotherapy (group A), and at other time in the other 115 patients (group B). Total mesorectal excision was done at 4 to 6 weeks after the completion of chemoradiation. The radiosensitizing effect of capecitabine was evaluated on the basis of the pathological response.
RESULTS
Complete pathological regression of the primary tumor was observed in 12 patients (21.4%) for group A and in 11 patients (9.6%) for group B (p=0.031). Residual disease less than 0.5 cm (a good response) was observed in 19 patients (33.9%) for group A and in 23 patients (20.0%) for group B (p=0.038). On multivariate analysis, the capecitabine ingestion time showed marginal significance.
CONCLUSION
When performing preoperative chemoradiation for locally advanced rectal cancer, the radiosensitizing effect of capecitabine was enhanced when it was administered 1 hour before radiotherapy.

Keyword

Rectal neoplasms; Combined modality therapy; Capecitabine

MeSH Terms

Administration, Oral
Combined Modality Therapy
Eating
Humans
Multivariate Analysis
Plasma
Radiation-Sensitizing Agents
Radiotherapy
Rectal Neoplasms*
Retrospective Studies
Capecitabine
Radiation-Sensitizing Agents

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