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
412P - The evaluation of chromosomal changes in patients with osteosarcoma
Presenter: Nargiza Karimova
Session: Poster display session
Resources:
Abstract
413P - The state of molecular biological markers in osteosarcoma
Presenter: Djamilya Polatova
Session: Poster display session
Resources:
Abstract
414P - Clinical profile of gastrointestinal stromal tumour in Yangon General Hospital
Presenter: Khin Mu
Session: Poster display session
Resources:
Abstract
415P - Adult soft tissue myoepithelial carcinoma: Treatment outcomes and efficacy of chemotherapy
Presenter: Florence Chamberlain
Session: Poster display session
Resources:
Abstract
417P - Clinicopathological profile and survival outcomes of sarcomas from a regional cancer centre in South India
Presenter: Divya Bharathi
Session: Poster display session
Resources:
Abstract
418P - Lessons learnt from treatment of foot sarcomas: Analysis from dedicated sarcoma clinic in North India
Presenter: Satyajit Pawar
Session: Poster display session
Resources:
Abstract
423P - Effectiveness of first-generation 5HT3 receptor antagonist plus dexamethasone plus aprepitant in controlling delayed chemotherapy-induced nausea and vomiting in patients with colorectal cancer: A propensity score-matched analysis
Presenter: Toshinobu Hayashi
Session: Poster display session
Resources:
Abstract
424P - Cancer worry, genetic knowledge, and attitudes towards NGS multigene panel testing among Korean breast cancer patients
Presenter: Ji Soo Park
Session: Poster display session
Resources:
Abstract
425P - Economic and safety evaluation of 5-HT3 recepter antagonist conversion from palonosetron to granisetron in highly and moderately emetogenic chemotherapy: A prospective study
Presenter: Keisuke Yamakita
Session: Poster display session
Resources:
Abstract
426P - Impaired quality of life of caregivers of patients with gastrointestinal cancer undergoing palliative chemotherapy
Presenter: Nobumichi Takeuchi
Session: Poster display session
Resources:
Abstract