Skip Navigation


Annals of Oncology Advance Access originally published online on May 2, 2006
Annals of Oncology 2006 17(7):1103-1110; doi:10.1093/annonc/mdl085
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
17/7/1103    most recent
mdl085v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (6)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Calvo, F. A.
Right arrow Articles by Álvarez, E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Calvo, F. A.
Right arrow Articles by Álvarez, E.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 2006 European Society for Medical Oncology

Improved incidence of pT0 downstaged surgical specimens in locally advanced rectal cancer (LARC) treated with induction oxaliplatin plus 5-fluorouracil and preoperative chemoradiation

F. A. Calvo1,*, F. J. Serrano2, J. A. Diaz-González2, M. Gomez-Espi2, E. Lozano2, R. Garcia2, D. de la Mata2, J. A. Arranz3, P. García-Alfonso3, G. Pérez-Manga3 and E. Álvarez4

1 Department of Oncology; 2 Radiation Oncology Service; 3 Medical Oncology Service; 4 Department of Pathology, Hospital General Universitario Gregorio Marañón, Madrid, Spain

* Correspondence to: Prof. F. A. Calvo, Chairman Department of Oncology, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo 46, 28007 Madrid, Spain. Tel. +34 91 586 85 99; Fax +34 91 586 80 18; E-mail: fcalvo.hgugm{at}salud.madrid.org

Purpose: To compare efficacy in terms of pathologic response in LARC patients treated with preoperative chemoradiation, with or without a short-intense course of induction oxaliplatin.

Patients and Methods: From 05/98 to 10/02, 114 patients were treated with preoperative chemoradiation (4500–5040 cGy + oral Tegafur 1200 mg/day) for cT3-4N+/xM0 rectal cancer. Starting 05/01, 52 consecutive patients additionally received induction FOLFOX-4, oxaliplatin (85 mg/m2 iv d1), 5-FU (400 mg/m2 iv bolus d1) and 600 mg/m2 iv continuous infusion in 22 h with leucovorin (200 mg iv) d1 and d2, every 15 days (2 cycles), followed by the previously described Tegafur chemoradiation regime. Surgery was performed in 5–6 weeks. Pathological assessment investigated post-treatment T and N status in the rectal wall and peri-rectal tissues.

Results: Patients, tumor and treatment characteristics were comparable between groups. Incidence of pT0 specimens was significantly increased by induction FOLFOX-4 (P = 0.006). Total T and N downstaging were 58% versus 75% and 42% versus 40%, respectively (P = ns). T downstaging of ≥2 categories was significantly superior in FOLFOX-4 group (P = 0.029).

Conclusions: Short-intense induction FOLFOX-4 significantly improves pathologic complete response in LARC patients treated with tegafur-sensitized preoperative chemoradiation. The 44% rate of pT0-1 specimens observed in the oxaliplatin group should impulse innovative surgical approaches to promote ano-rectal sphincter conserving protocols.

Key words: neoadjuvant oxaliplatin, chemoradiation, tegafur, rectal cancer, downstaging


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 JCOHome page
C. Rodel, T. Liersch, R. M. Hermann, D. Arnold, T. Reese, M. Hipp, A. Furst, N. Schwella, M. Bieker, G. Hellmich, et al.
Multicenter Phase II Trial of Chemoradiation With Oxaliplatin for Rectal Cancer
J. Clin. Oncol., January 1, 2007; 25(1): 110 - 117.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.