Interim analysis of a randomized trial of radiation therapy of rectal cancer with/without WR-2721.
The objectives of this randomized trial are to define the maximum tolerated dose of radiation therapy, at curative dose levels, that can be delivered following WR-2721, and to observe the anti-tumor effects and normal tissue responses. One hundred patients with inoperable, unresectable, or recurrent rectal cancer were stratified and randomized to radiation only, or WR-2721 and radiation. The entire pelvis is treated with 4 portals 4 times a week to a total of 4500 cGy (first level dose) in 5 weeks. WR-2721, 340 mg/m2 was given 15 minutes before radiation to the combination group. Subsequently, both groups received a conedown of 720 cGy in 4 days to 144(2) cm portals APPA, and if originally inoperable or unresectable 720 cGy in four days to second conedown of 64(2) cm. Patients were observed from 3 to 18 months (median = 12 months). No significant hypotension or hematologic toxicity occurred in the WR-2721 treated group. Mild to moderate emesis occurred in 80% of the courses. (No antiemetics were used.) Moderate or severe acute toxicities to normal tissues were observed less frequently in the WR-2721 arm. No moderate or severe late toxicities to the skin, mucous membrane, urinary bladder or intestine was observed in the WR-2721 group, however, 5 patients treated with radiation alone experienced moderate or severe late toxicity to these organs. No evidence of tumor protection was observed.
Kligerman
M M
MM
Department of Radiation Oncology, University of Pennsylvania 19104.
Liu
T
T
Liu
Y
Y
Scheffler
B
B
He
S
S
Zhang
Z
Z
D000230:Adenocarcinoma / Q000188:drug therapy / Q000532:radiotherapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D004999:Amifostine / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D006801:Humans; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*
D004999:Amifostine