Low-dose chemotherapy is practically useful for the patients with intrapelvic recurrence of rectal cancer.
The aim was to assess the practical efficacy of low-dose chemotherapy in patients with intrapelvic recurrence of rectal cancer without radiotherapy.


METHODS
The records of 13 patients treated with low-dose chemotherapy for intrapelvic recurrence of rectal cancer between 1996 and 2003 were retrospectively reviewed. The patients had received low-dose leucovorin and 5-fluorouracil (LV/5-FU) as first-line and low-dose irinotecan and cisplatin regimen (CPT-11/CDDP) as second-line therapy without radiotherapy.


RESULTS
With the LV/5-FU treatment, no patients showed a complete response (CR), two patients showed a partial response (PR), three patients had stable disease (SD), and eight patients experienced progressive disease (PD), giving a response rate (RR) of 15.4% and a disease control rate (DCR) of 38.5%. With the CPT-1/CDDP treatment, no patients showed CR or PR, three patients had SD, and ten patients had PD, which results in a DCR of 23.1%. The progression-free survival (PFS) of LV/5-FU and CPT-11/CDDP were 4.7 months and 4.7 months respectively. The median survival time (MST) of all the patients was 17.3 months. There were no patients who experienced grade 3 or 4 of any adverse reaction during the course of these regimens.


CONCLUSIONS
The results suggest that low-dose chemotherapy for intrapelvic recurrence of rectal cancer without radiotherapy could be acceptable. For patients who refused radiotherapy in order to avoid adverse effects, these low-dose low toxicity chemotherapy regimens might be recommended.
Yoshimatsu
Kazuhiko
K
Department of Surgery, Tokyo Women's Medical University Medical Center East, Arakawa-ku, Tokyo, Japan.
Yokomizo
Hajime
H
Fujimoto
Takashi
T
Umehara
Arihiro
A
Otani
Taisuke
T
Matsumoto
Atsuo
A
Osawa
Gakuji
G
Shiozawa
Shunichi
S
Katsube
Takao
T
Naritaka
Yoshihiko
Y
Ogawa
Kenji
K
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010388:Pelvis; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000401:mortality*
D002955:Leucovorin; D005472:Fluorouracil