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
259P - The BOT patients fail to benefit from surgical staging procedures in prognosis and fertility outcomes: A retrospective analysis
Presenter: Li Na
Session: Poster display session
Resources:
Abstract
260P - Malignant ovarian germ cell tumours (MOGCT): Treatment results of 149 pts
Presenter: Dzhennet Chekini
Session: Poster display session
Resources:
Abstract
261P - Ovarian germ cell tumours - challenges and outcomes from a tertiary care centre in South India
Presenter: Vishnu Sreedath
Session: Poster display session
Resources:
Abstract
262P - Gestational trophoblastic tumours: Experience of the medical oncology department Hassan II University Hospital-Morocco about 29 cases
Presenter: Karima Oualla
Session: Poster display session
Resources:
Abstract
263TiP - ATHENA (GOG-3020/ENGOT-ov45): A randomised, double-blind, placebo-controlled phase III study of the poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib + the PD-1 inhibitor nivolumab following frontline platinum-based chemotherapy in ovarian cancer
Presenter: Keiichi Fujiwara
Session: Poster display session
Resources:
Abstract
264TiP - ENGOT-ov43/KEYLYNK-001: A phase III trial of pembrolizumab plus chemotherapy with olaparib maintenance for first-line treatment of BRCA¬-nonmutated advanced epithelial ovarian cancer
Presenter: Keiichi Fujiwara
Session: Poster display session
Resources:
Abstract
265TiP - KEYNOTE-826: A phase III randomized study of chemotherapy with or without pembrolizumab for first-line treatment of persistent, recurrent, or metastatic cervical cancer
Presenter: Keiichi Fujiwara
Session: Poster display session
Resources:
Abstract
271P - Comparison between CHOP like regimens and DAEPOCH with or without Rituximab in adult high grade B cell lymphoma NOS; A retrospective study from a tertiary cancer hospital in South India
Presenter: LALATENDU MOHARANA
Session: Poster display session
Resources:
Abstract
272P - Melatonin increases the chemosensitivity of diffuse large Bell lymphoma cells to Epirubicin by inhibiting P-glycoprotein expression via the NF-κB pathway
Presenter: Xiuhua Sun
Session: Poster display session
Resources:
Abstract
273P - MALT1- A20 and NF-κB expression pattern in patients with non-Hodgkin lymphomas
Presenter: Alshimaa Alhanafy
Session: Poster display session
Resources:
Abstract