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

2006; Korean Academy of Medical Sciences; Volume: 21; Issue: 1 Linguagem: Inglês

10.3346/jkms.2006.21.1.52

1598-6357

Kim Js, Jun-Sang Kim, Moon-June Cho, Wan Hee Yoon, Kye-Sang Song,

Colorectal Cancer Treatments and Studies

Comparison of the Efficacy of Oral Capecitabine versus Bolus 5-FU in Preoperative Radiotherapy of Locally Advanced Rectal CancerThe 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/m 2 /day) plus leucovorin (LV, 20 mg/m 2 /day) (Group I).Another LARC group received concurrent chemoradiation using two cycles 1,650 mg/m 2 /day of oral capecitabine and 20 mg/m 2 /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.