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Annals of Oncology 14:570-573, 2003
© 2003 European Society for Medical Oncology

Original Paper

Raltitrexed plus radiotherapy for the treatment of unresectable/recurrent rectal cancer: a phase I study

R. D. James1,+, N. Botwood2, C. C. Vernon2 and P. Price3

1 The Kent Oncology Centre, Maidstone Hospital, Kent; 2 Department of Clinical Oncology, Hammersmith Hospital, London; 3 Department of Radiation Oncology, Christie Hospital, Manchester, UK

Received 26 March 2002; revised 13 November 2002; accepted 3 December 2002

Background:

Current consensus is that a combination of radiotherapy and chemotherapy may provide the optimal treatment for patients with unresectable rectal cancer. Raltitrexed has proven efficacy in the treatment of advanced colorectal cancer and has an acceptable toxicity profile. The aim of this phase I study was to determine the recommended dose of raltitrexed in combination with radiotherapy in patients with unresectable/recurrent rectal cancer.

Patients and methods:

Patients were treated with radiotherapy (25 fractions at 2.0 Gy per fraction) five times per week for 5 weeks. Raltitrexed was administered on days 1 and 22 at 2.0, 2.6 and 3.0 mg/m2.

Results:

A total of 20 patients were entered into the study. Dose-limiting toxicities were recorded in three of 20 patients following the first dose of raltitrexed; one patient at 2.6 mg/m2 (grade 3 diarrhoea, grade 3 neutropenia and grade 2 pyrexia) and two patients at 3.0 mg/m2 (one grade 3 neutropenia and one grade 4 diarrhoea). The most common non-haematological and haematological treatment-related adverse events were diarrhoea (11 of 20, two grade 3, one grade 4) and leukopenia (eight of 20, one grade 3, one grade 4), respectively.

Conclusions:

The recommended dose of raltitrexed in combination with radiotherapy for future studies is 2.6 mg/m2.

Key words: chemoradiotherapy, phase I, radiotherapy, raltitrexed, rectal cancer


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