178P - Additional preoperative chemotherapy between preoperative chemoradiotherapy and surgery in patients with locally advanced rectal cancer

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Anticancer Agents
Rectal Cancer
Surgical Oncology
Presenter Jin Hwa Choi
Citation Annals of Oncology (2016) 27 (suppl_9): ix53-ix67. 10.1093/annonc/mdw581
Authors J.H. Choi1, S.E. Park2, C.H. Choi2, J.W. Kim2, B.G. Kim3, J.S. Jang2, I.G. Hwang2
  • 1Radiation Oncology, Chung-Ang University Hospital, 06973 - Seoul/KR
  • 2Internal Medicine, Chung-Ang University Hospital, 06973 - Seoul/KR
  • 3General Surgery, Chung-Ang University Hospital, 06973 - Seoul/KR



The aim of this study is evaluate the efficacy and the safety of addition 4-week chemotherapy with 5-Fluorouracil (5-FU) and leucovorin (LV) during the resting periods between preoperative chemoradiotherapy (CRT) and surgery in patients with locally advanced rectal cancer.


Preoperative CRT was delivered to the whole pelvis a 45 Gy in 25 fractions and a 5.40 Gy boost within gross tumor with concurrent 5-FU or capecitabine for 6 weeks. Patients received additional preoperative chemotherapy two cycles of 5-FU and LV (LV 200mg/m2 and 5-FU bolus 400mg/m2 on day 1, and 5-FU infusion 2400mg/m2 for 46hrs, every 2 weeks) after preoperative CRT. Surgery was performed 2∼4 weeks following the completion of preoperative chemotherapy.


Between 2009 March and 2015 January, 32 patients were enrolled and surgery, 31 patients completed the scheduled treatment. Pathologic complete remission (pCR) was noted in 4 patients (15.6%) and down-staging was observed in 16 (50%). T down-staging and N down-staging were observed in 20(62.5%) and 19(59.4%), respectively. Grade 3 to 5 toxicity was noted 2 patients (6.2%). The pCR rate was similar with the pCR rates obtained after conventional preoperative CRT, but down staging rate was improved.


This study showed that additional 4-week chemotherapy with 5-FU and LV during resting periods after 6-week preoperative CCRT is well tolerable and active and compares favorably with conventional preoperative CRT.

Clinical trial indentification


Legal entity responsible for the study





All authors have declared no conflicts of interest.