title: Preoperative radiochemotherapy in rectal cancer: long-term results of a phase II trial.
abstract: OBJECTIVE
  To assess toxicity and long-term results of preoperative chemoradiotherapy in rectal cancer.
  
  
  METHODS
  Between 1989 and 1997, as a phase II study, 66 patients with T3 M0, rectal cancer received preoperatively a 45 Gy dose pelvic radiotherapy (XRT) combined with two 5-day chemotherapy courses (CT) of 5-Fluorouracil (5-FU) and Leucovorin (LV) delivered the first and fifth week of XRT. For each CT course, LV:20 mg/m2/d1-d5,. While the 5-FU dose was variable from 450 to 350 mg/m2/d first course and 370 to 350 mg/m2/d second course. Surgery was planned 3 weeks later.
  
  
  RESULTS
  XRT-CT was stopped in 1 patient due to progressive disease. CT was stopped in 1 patient due to toxicity. Grades 2 and 3 diarrhea were observed in 8 and 3 patients, respectively. One patient died from acute diarrhea due to deviation from recommendations; 60 patients went to surgery. Among the 58 patients operated on for cure, 5 had an R1-resection. After a 4.5-year median follow-up, the 5-year pelvic disease-free survival was 92% for the whole group and 96% in the R0-resection group.
  
  
  CONCLUSIONS
  Preoperative combined XRT-5-FU-LV is feasible if optimal XRT and patients are carefully managed. The recommended 5-FU daily dose is 350 mg/m2 for both CT courses. This approach is currently tested in a large EORTC phase III trial.
authors.affiliation: Department of Radiotherapy, University Hospital Besançon, France. jean-françois.bosset@ufc-chu.univ.fcomte.fr
authors.forename: J F
authors.initials: JF
authors.lastname: Bosset
authors.forename: V
authors.initials: V
authors.lastname: Magnin
authors.forename: P
authors.initials: P
authors.lastname: Maingon
authors.forename: G
authors.initials: G
authors.lastname: Mantion
authors.forename: E P
authors.initials: EP
authors.lastname: Pelissier
authors.forename: M
authors.initials: M
authors.lastname: Mercier
authors.forename: G
authors.initials: G
authors.lastname: Chaillard
authors.forename: J C
authors.initials: JC
authors.lastname: Horiot
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D016019:Survival Analysis
chemical_list: D000964:Antimetabolites, Antineoplastic; D002955:Leucovorin; D005472:Fluorouracil