title: Pre-operative chemoradiotherapy with oral tegafur-uracil and leucovorin for rectal cancer.
abstract: BACKGROUND
  To evaluate the efficacy and toxicity of pre-operative radiotherapy (RT) combined with oral tegafur-uracil (UFUR) plus leucovorin (LV) in rectal cancer.
  
  
  METHODS
  Sixty-five patients with rectal adenocarcinoma (clinical staged T2-4N0-2M0) received pelvic RT of 45 Gy in 20 fractions over 28 days. Concurrent chemotherapy consisted of UFUR (200 mg/m(2)/day) and LV (45 mg/day) on day 1-28. UFUR (250 mg/m(2)/day) and LV were continued on day 36-63. Surgery was performed on day 70.
  
  
  RESULTS
  Sixty-three patients completed the concurrent chemoradiotherapy (CCRT) and 56 received curative or palliative surgery. Among the 52 patients receiving curative resection, downstaging (DS) occurred in 39 (75%), pathological complete response in 13 (25%), and sphincter preservation was achieved in 16 of 29 (55%) with lower-seated tumors. With a median follow-up time of 33 months, local failure developed in 4 (8%) and distant metastases occurred in 7 (14%). The 3-year overall survival was 92% and disease-free survival 76%. For all 65 patients, grade 3-4 diarrhea developed in 6 (9%) and grade 3-4 leucopenia observed in 2 (3%).
  
  
  CONCLUSIONS
  Oral UFUR + LV administered with pre-operative RT are effective in tumor DS, pathological complete response, and sphincter preservation with tolerable toxicity in rectal cancer.
authors.affiliation: Cancer Center, Taipei Veterans General Hospital & National Yang-Ming University, School of Medicine, Taipei, Taiwan, Republic of China.
authors.forename: Ling-Wei
authors.initials: LW
authors.lastname: Wang
authors.forename: Shung-Haur
authors.initials: SH
authors.lastname: Yang
authors.forename: Jen-Kou
authors.initials: JK
authors.lastname: Lin
authors.forename: Tzu-Chen
authors.initials: TC
authors.lastname: Lin
authors.forename: Wing-Kai
authors.initials: WK
authors.lastname: Chan
authors.forename: Wei-Shone
authors.initials: WS
authors.lastname: Chen
authors.forename: Huann-Sheng
authors.initials: HS
authors.lastname: Wang
authors.forename: Jeng-Kae
authors.initials: JK
authors.lastname: Jiang
authors.forename: Rheun-Chuan
authors.initials: RC
authors.lastname: Lee
authors.forename: A Fen-Yau
authors.initials: AF
authors.lastname: Li
authors.forename: Yee
authors.initials: Y
authors.lastname: Chao
authors.forename: Kwan-Hwa
authors.initials: KH
authors.lastname: Chi
authors.forename: Sang-Hue
authors.initials: SH
authors.lastname: Yen
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004338:Drug Combinations; D005260:Female; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D015996:Survival Rate; D005641:Tegafur / Q000008:administration & dosage; D014498:Uracil / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; C096910:UFT(R) drug; D005641:Tegafur; D014498:Uracil; D002955:Leucovorin