【摘 要】
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Background: Locally advanced rectal adenocarcinoma is typically treated by neoadjuvant chemo-radiotherapy and surgery.We assessed the effect of an additional cycle of capecitabine/oxaliplatin chemothe
【机 构】
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Department of Radiation Oncology, The Affiliated Union Hospital of Fujian Medical University, Fuzhou
【出 处】
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第九届泛珠江区域放射肿瘤学学术大会暨肿瘤放射治疗多中心协作研讨会、重庆市医学会放射肿瘤治疗学专业委员会2014年会
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Background: Locally advanced rectal adenocarcinoma is typically treated by neoadjuvant chemo-radiotherapy and surgery.We assessed the effect of an additional cycle of capecitabine/oxaliplatin chemotherapy before surgery in 57 patients with rectal cancer.Materials and Methods: Radiotherapy (total dose, 50.4 Gy) was combined with three cycles of chemotherapy (two cycles concomitant with radiotherapy), and each cycle consisted of oxaliplatin (130 mg/m2 on day-l) and capecitabine (825 mg/m2, twice per day from day-1 to day-14) for 21 days.The primary end-point was pathological complete response (pCR).The secondary end-point was change in the pre-treatment and post-treatment tumor and node stages.Results: Eleven patients (19%) experienced complete tumor regression and 23 patients (40%) experienced tumor regression grade (TRG) 3.Tumor down-staging occurred in 31 patients (54.4%), and down-staging of nodes occurred in 25 patients (43.9%).There was a significant difference in tumor stage before treatment and after surgery (p < 0.001).Patients with less advanced N-stages had significantly better recurrence-free survival, but similar metastasis-free survival and overall survival.The TRG grade was not associated with overall survival, recurrence-free survival and metastasis-free survival.The most common adverse events were pulmonary infection (n =6, 10.5%) and intestinal obstruction (n =6, 10.5%).Conclusions: An additional cycle of chemotherapy given after chemo-radiotherapy and before surgery provided good efficacy and had a satisfactory safety profile in patients with rectal cancer.
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