Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster display - Cocktail

774 - Long term outcomes of preoperative concurrent CapeOx/RT in locally advanced rectal cancer

Date

24 Nov 2018

Session

Poster display - Cocktail

Presenters

Ekaphop Sirachainan

Citation

Annals of Oncology (2018) 29 (suppl_9): ix28-ix45. 10.1093/annonc/mdy431

Authors

E. Sirachainan1, C. Sitathanee2, W. Suwanthanma3, N. Larbcharoensub4, S. Lukrak1, N. Sripaiboonkit Thokanit5, S. Phongkitkarun6, K. Sumboonnanonda3

Author affiliations

  • 1 Medicine, Ramathibodi Hospital, 10400 - Bangkok/TH
  • 2 Radiology, Ramathiboi, 10400 - Bangkok/TH
  • 3 Surgery, Ramathibodi Hospital, 10400 - Bangkok/TH
  • 4 Pathology, Ramathibodi Hospital, 10400 - Bangkok/TH
  • 5 Tumor Registry, Ramathibodi Hospital, 10400 - Bangkok/TH
  • 6 Radiology, Ramathibodi Hospital, 10400 - Bangkok/TH
More

Resources

Abstract 774

Background

Capecitabine and oxaliplatin (CapeOx) regimen demonstrated substantial benefit in advanced colorectal cancer. However using this regimen concurrently with RT in locally advanced rectal cancer showed similar outcomes as capecitabine/RT. The long-term outcomes of preoperative concurrent CapeOx/RT in these patients have been investigated.

Methods

We conducted a phase II study to determine the efficacy of preoperative concurrent CapeOx-RT in locally advanced rectal cancer (cT3-4 or N+). Capecitabine 1,650 mg/m2/day was taken on day 1-14 and 22-35 of RT. Oxaliplatin 50 mg/m2was administered on day 1, 8, 22 and 29 of RT. The radiation dose to the pelvis was 45 Gy/25 fractions with a boost dose of 5.4 Gy/3 fractions. The total dose to the tumor bed was 50.4 Gy/28 fractions. Patients underwent surgery after completion of radiotherapy. Dworak tumor regression grading (TRG) was used to determine pathological response. The patients were allowed to receive adjuvant chemotherapy.

Results

Twenty patients were accrued. 55% was male. All patients had clinical T3 N positive disease except one had T4 disease. Pathological response was evaluable in 19 patients. Dworak TRG 1-2 and 3-4 were detected in 36.8% and 63.2% respectively. After median follow-up of 5.93 years, five patients (25%) developed recurrent distant metastatic disease and finally expired. No recurrent disease occurred after 2.39 years. The 5-year DFS and OS were 75% and 80% respectively. Although no statistically significant difference was found, patients with Dworak TRG 1-2 had lower 5-year DFS and OS than those with TRG 3-4 (TRG 1-2, DFS 66.7% vs. TRG 3-4, DFS 100%, p=.058 and TRG 1-2, OS 66.7% vs. TRG 3-4, OS 100%, p=.059 respectively). At present, all patients with Dworak TRG 3-4 are alive and have never had recurrent disease.

Conclusions

Most locally advanced rectal cancer patients receiving preoperative concurrent CapeOx/RT achieved best Dworak TRG. Long-term outcomes of these patients, especially with good response, were excellent. Larger studies may be needed to determine the association of Dworak TRG and survival.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Ramathibodi Comprehensive Cancer Center.

Funding

Mahidol University.

Disclosure

All authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.