Korean J Clin Oncol.  2017 Dec;13(2):147-151. 10.14216/kjco.17023.

The outcomes of intensified 5-fluorouracil plus leucovorin chemotherapy for preoperative chemoradiation in rectal cancers

• Ha N
• Hong KD
• Ji WB
• Kim JS
• Um JW

• KMID: 2405657
• DOI: http://doi.org/10.14216/kjco.17023

Abstract

PURPOSE
The clinical benefit of intensified neoadjuvant chemoradiotherapy (CRT) in rectal cancer has not been proved. We investigated clinical outcomes of intensified 5-fluorouracil plus leucovorin (5-FU/LV) chemotherapy.
METHODS
We retrospectively analyzed 45 patients with locally advanced rectal adenocarcinoma who underwent neoadjuvant CRT between 2010 and 2015. Intensified group took additional 1 cycle of 5-FU/LV chemotherapy after radiation completion (resting period) before surgery, compared to conventional group.
RESULTS
Eighteen patients were in conventional group and 27 were in intensified group. Median follow-up duration was 33.7 months (range, 7.8-75.6 months). Complete response rate was 11.4% (5/45). Twelve patients in conventional group and 16 patients in intensified group achieved downstaging (P=0.435). In aspect of toxicity, anemia and thrombocytopenia tended to be more frequent in intensified group without statistical difference. There was also no difference in survival between two groups.
CONCLUSION
The intensified CRT with additional 1 cycle of 5-FU/LV in rectal cancer revealed no clinical benefit compared to conventional regimen. Considering that the adverse event was minimal and generally acceptable, further research with additional cycles of 5-FU/LV is needed to prove a real benefit of intensified CRT.

Keyword

5-fluorouracil; Rectal neoplasms; Consolidation chemotherapy

MeSH Terms

Adenocarcinoma
Anemia
Chemoradiotherapy
Consolidation Chemotherapy
Drug Therapy*
Fluorouracil*
Follow-Up Studies
Humans
Leucovorin*
Rectal Neoplasms*
Retrospective Studies
Thrombocytopenia
Fluorouracil
Leucovorin