Post-operative concurrent chemoradiation therapy using oral uracil-tegafur versus weekly intravenous fluorouracil for locally advanced rectal cancer.
BACKGROUND
This prospective, nonrandomized study was conducted to compare the efficacy and toxicity of post-operative concurrent chemoradiation therapy (CCRT) using daily oral uracil-tegafur plus leucovorin (UFUR/LV) vs. weekly intravenous fluorouracil plus leucovorin (5-FU/LV) in patients with locally advanced rectal cancer.


METHODS
From November 1996 through December 2004, 30 patients with stage II or III rectal cancer were enrolled. Either 5-FU (400 to 450 mg/m2) plus LV (80 to 100 mg/m2) weekly or oral UFUR (250 to 300 mg/m2/d) plus oral LV (30 to 45 mg/m2/d) were given during radiotherapy. Radiation (50.4 to 60.4 Gy) was delivered to the tumor bed in 28-33 fractions.


RESULTS
The mean survival, 2-year overall survival and disease-free survival were 36 months vs. 30 months, 68% vs. 66% and 55% vs. 50%, (p > 0.05), in the UFUR/LV and 5-FU/LV groups, respectively. There were no treatment-related deaths or grade 4 toxicity in either group. Grade 3 dermatitis, gastrointestinal and hematologic toxicity were noted in the 5-FU/LV group.


CONCLUSIONS
Because of a similar survival rate and lower toxicity, oral UFUR/LV is suggested as an alternative regimen to intravenous 5-FU/LV in post-operative CCRT of locally advanced rectal cancer.
Hsieh
Chen-Hsi
CH
Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan.
Chen
Yu-Jen
YJ
Chang
Kou-Hwa
KH
Hsu
Hsi-Hsien
HH
Liu
Chien-Kuo
CK
Hung
Shih-Kai
SK
Chen
Hong-Wen
HW
Lai
Yuen-Liang
YL
Hsu
Tzu-Chi
TC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D005641:Tegafur / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D005641:Tegafur; D005472:Fluorouracil