Abstract 85P
Background
The purpose of this study was to compare the oncological outcomes of three preoperative chemotherapy regimens, capecitabine alone (Cap), capecitabine plus oxaliplatin (CapOx) and capecitabine plus irinotecan (CapIri), concurrent with long-course pelvic radiotherapy for patients with locally advanced rectal cancer (LARC) at a Chinese comprehensive cancer center.
Methods
LARC (T3/4 and/or LN+) cases receiving neoadjuvant treatment between Mar 2006 and Feb 2018 were reviewed. Preoperative chemoradiotherapy consisted standard fractionated pelvic radiotherapy concurrently with chemotherapy of capecitabine alone, CapOx or CapIri. Total mesorectal excision was planned 6-10 weeks after the completion of chemoradiotherapy. Tumor response, neoadjuvant treatment toxicity and surgical complications of the three cohorts were compared analyzed.
Results
A total of 1165 patients were included in the study. 445 patients received concurrent capecitabine alone, 353 received CapOx and 367 received CapIri. An abdominoperineal resection or Hartmann’s procedure was performed in 46.4%, 59.8% and 47.2% of the patients who underwent surgery in the Cap, CapOx and CapIri cohorts, respectively (P = 0.001). The complete response (CR) rate (including pathological CR and clinical CR) was 20.7%, 18.7% and 28.6% in three cohorts (P = 0.003). Multivariate analysis showed that a lower tumor location, normal baseline CEA levels and the CapIri regimen were associated with a higher CR rate. Significantly more grade 3-4 toxicity was reported in the CapIri cohort than in the other two cohorts. Patients in the CapOx cohort were more likely to report surgical complications than the other patients (Cap vs CapOx vs CapIri: 13.4% vs 21.1% vs 13.3%, P = 0.005).
Conclusions
Concurrent CapIri chemotherapy during preoperative pelvic radiotherapy significantly improved the CR rate but added toxicity compared with capecitabine alone or CapOx regimen. Long-term follow-up will determine if this short-term benefit translates into an improved survival.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
206P - Population-based validation of the risk stratification among prostate cancer patients
Presenter: Mu Xie
Session: Poster display session
Resources:
Abstract
211P - Adjuvant axitinib in Asian vs non-Asian patients with metastatic renal cell carcinoma (mRCC): ATLAS trial subgroup analysis
Presenter: Chi Fai Ng
Session: Poster display session
Resources:
Abstract
212P - Immunotherapy with nivolumab in metastatic renal cell carcinoma patients in India: Bringing a change in clinical practice
Presenter: Amit Rauthan
Session: Poster display session
Resources:
Abstract
213P - An observational retrospective real-world study of sarcomatoid renal cell carcinoma (sRCC) patients in an Asian cancer centre
Presenter: Ravindran Kanesvaran
Session: Poster display session
Resources:
Abstract
214P - Targeting epithelial-mesenchymal transition (EMT), novel strategy to delay resistance or re-sensitize renal cancer to Sunitinib
Presenter: Revati Sharma
Session: Poster display session
Resources:
Abstract
215P - Radiologic and pathologic tumour size variation in localized renal cell carcinoma and its implications
Presenter: Shanky Singh
Session: Poster display session
Resources:
Abstract
216P - Partial versus radical nephrectomy: 10- year long-term survival among patients with Wilms tumour
Presenter: Mira Mostafa
Session: Poster display session
Resources:
Abstract
217P - Neutrophil-to-lymphocyte ratio is a useful biomarker for predicting worse clinical outcome in chemo-resistant urothelial carcinoma patients treated with pembrolizumab
Presenter: Koichiro Ogihara
Session: Poster display session
Resources:
Abstract
219P - Long-term outcomes of bladder preservation in muscle-invasive bladder cancer patients
Presenter: Amanda Dania Satiti
Session: Poster display session
Resources:
Abstract
220P - An outcome analysis of robotassisted radical nephroureterectomy with extended template lymphadenectomy for upper tract urothelial carcinoma
Presenter: Ashwin Tamhankar
Session: Poster display session
Resources:
Abstract