title: The synchronization of chemotherapy to circadian rhythms and irradiation in pre-operative chemoradiation therapy with hyperthermia for local advanced rectal cancer.
abstract: OBJECTIVE
  The therapeutic and adverse effects of pre-operative chrono-chemoradiation with local hyperthermia for patients with rectal adenocarcinoma were evaluated.
  
  
  METHODS
  Pre-operative radiation therapy of a total dose of 40 Gy (n = 10) or 50 Gy (n = 19) on the whole pelvis and hyperthermia once a week during the radiation therapy for 1 h were performed for patients with T2-T4 rectal adenocarcinoma. Chemotherapy consisted of 5-FU (250 mg m-2 per day) and LV (25 mg m-2 per day) administered by continuous infusion in the night for 5 days a week in the second and fourth weeks of radiation.
  
  
  RESULTS
  Grade 3+ toxicities were seen only in two patients (6.9%). A significant down staging was seen in 41.4% of all cases and 52.6% of cases with a radiation dose of 50 Gy. Of the patients who had received surgical resection of a tumour, three (11.1%) had no residue pathologically in the specimen and eight (29.6%) had microscopic lesions.
  
  
  CONCLUSIONS
  These results yielded a high response rate with minimal toxicities for advanced low-rectal adenocarcinoma. The administration of 5-FU during the sleeping time before irradiation might have an advantage not only as a chronotherapy but also as a radiation sensitizer.
authors.affiliation: Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan. asaot@med.gunma-u.ac.jp
authors.forename: Takayuki
authors.initials: T
authors.lastname: Asao
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Sakurai
authors.forename: Kouichi
authors.initials: K
authors.lastname: Harashima
authors.forename: Satoru
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Soichi
authors.initials: S
authors.lastname: Tsutsumi
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Nonaka
authors.forename: Mariko
authors.initials: M
authors.lastname: Shioya
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakano
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D019454:Chronotherapy / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D016896:Treatment Outcome; D014803:Vitamin B Complex / Q000008:administration & dosage
chemical_list: D000964:Antimetabolites, Antineoplastic; D014803:Vitamin B Complex; D002955:Leucovorin; D005472:Fluorouracil