title: Chemoradiotherapy with 5-fluorouracil/leucovorin, surgery and adjuvant chemotherapy for locally advanced rectal cancer.
abstract: The aim of this study was to demonstrate a pathologic complete response (pCR) rate of at least 10% with an acceptable toxicity achieved by preoperative chemoradiotherapy with 5-fluorouracil (5-FU)/leucovorin in patients with locally advanced rectal cancer. Patients were treated by radiotherapy targeting 50 Gy and 5-FU/leucovorin intravenously during the 1st, 4th and 7th week after start of radiotherapy followed by surgery and adjuvant chemotherapy. In 71 evaluable patients, the pCR rate was 14.1% (95% CI, 6.0-22.2); the local relapse rate, 6.1%; the 5-year disease-free survival, 54% and the overall 5-year survival, 68%. The most severe adverse events were neutropenia (17%), diarrhoea (17%), infection (8%) and fatal cardiovascular function (1%). This therapy yielded a high rate of pCR, a low rate of local relapse and a long disease-free and overall survival. To increase its feasibility, radiation dose reduction to 45 Gy and administration of only two preoperative cycles of chemotherapy is recommended.
authors.affiliation: Ludwig Boltzmann Institute for Applied Cancer Research (LBI-ACR VIEnna), Cluster Translational Oncology, 3rd Medical Department - Centre for Oncology and Haematology, Kaiser Franz Josef-Spital, Vienna.
authors.forename: M
authors.initials: M
authors.lastname: Baur
authors.forename: M
authors.initials: M
authors.lastname: Horvath
authors.forename: S
authors.initials: S
authors.lastname: Stättner
authors.forename: A
authors.initials: A
authors.lastname: Schratter-Sehn
authors.forename: B
authors.initials: B
authors.lastname: Horvath
authors.forename: F
authors.initials: F
authors.lastname: Sellner
authors.forename: M
authors.initials: M
authors.lastname: Hudec
authors.forename: M
authors.initials: M
authors.lastname: Klimpfinger
authors.forename: C
authors.initials: C
authors.lastname: Dittrich
authors.forename: J
authors.initials: J
authors.lastname: Karner