Chemoradiotherapy with 5-fluorouracil/leucovorin, surgery and adjuvant chemotherapy for locally advanced rectal cancer

Baur,M.; Horvath,M.; Stättner,S.; Schratter-Sehn,A.; Horvath,B.; Sellner,F.; Hudec,M.; Klimpfinger,M.; Dittrich,C.; Karner,J.

doi:10.3892/ol_00000035

Chemoradiotherapy with 5-fluorouracil/leucovorin, surgery and adjuvant chemotherapy for locally advanced rectal cancer

Authors:
- M. Baur
- M. Horvath
- S. Stättner
- A. Schratter-Sehn
- B. Horvath
- F. Sellner
- M. Hudec
- M. Klimpfinger
- C. Dittrich
- J. Karner
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Affiliations: Ludwig Boltzmann Institute for Applied Cancer Research (LBI-ACR VIEnna), Cluster Translational Oncology, 3rd Medical Department - Centre for Oncology and Haematology, Kaiser Franz Josef-Spital, Vienna, Austria
Published online on: January 1, 2010 https://doi.org/10.3892/ol_00000035
Pages: 189-194

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Abstract

The aim of this study was to demonstrate a pathologic complete response (pCR) rate of at least 10% with an acceptable toxicity achieved by preoperative chemoradiotherapy with 5-fluorouracil (5-FU)/leucovorin in patients with locally advanced rectal cancer. Patients were treated by radiotherapy targeting 50 Gy and 5-FU/leucovorin intravenously during the 1st, 4th and 7th week after start of radiotherapy followed by surgery and adjuvant chemotherapy. In 71 evaluable patients, the pCR rate was 14.1% (95% CI, 6.0-22.2); the local relapse rate, 6.1%; the 5-year disease-free survival, 54% and the overall 5-year survival, 68%. The most severe adverse events were neutropenia (17%), diarrhoea (17%), infection (8%) and fatal cardiovascular function (1%). This therapy yielded a high rate of pCR, a low rate of local relapse and a long disease-free and overall survival. To increase its feasibility, radiation dose reduction to 45 Gy and administration of only two preoperative cycles of chemotherapy is recommended.

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