title: Raltitrexed plus radiotherapy for the treatment of unresectable/recurrent rectal cancer: a phase I study.
abstract: 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.
  
  
  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/m(2).
  
  
  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/m(2) (grade 3 diarrhoea, grade 3 neutropenia and grade 2 pyrexia) and two patients at 3.0 mg/m(2) (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/m(2).
authors.affiliation: The Kent Oncology Centre, Maidstone Hospital, UK. rjames@koc.mtw-tr.nhs.uk
authors.forename: R D
authors.initials: RD
authors.lastname: James
authors.forename: N
authors.initials: N
authors.lastname: Botwood
authors.forename: C C
authors.initials: CC
authors.lastname: Vernon
authors.forename: P
authors.initials: P
authors.lastname: Price
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000494:pharmacology*; D003131:Combined Modality Therapy; D003967:Diarrhea / Q000139:chemically induced; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D009503:Neutropenia / Q000139:chemically induced; D011799:Quinazolines / Q000008:administration & dosage / Q000494:pharmacology*; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D013876:Thiophenes / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D000964:Antimetabolites, Antineoplastic; D011799:Quinazolines; D013876:Thiophenes; C068874:raltitrexed