title: Evaluation of capecitabine and oxaliplatin administered prior to and then concomitant to radiotherapy in high risk locally advanced rectal cancer.
abstract: OBJECTIVE
  Systemic failure remains a predominant issue in locally advanced rectal cancer (LARC). A new strategy using capecitabine and oxaliplatin (XELOX regimen) administered prior to and then concomitant to radiotherapy for high risk LARC is developed in our practice. The aim of the present study was to evaluate the short-term efficacy and toxicities of this strategy.
  
  
  METHODS
  Patients were treated with one cycle XELOX regimen (oxaliplatin 130 mg/m(2) on day 1 with capecitabine 1,000 mg/m(2) twice daily for 14 days every 3 weeks), followed by chemoradiation (50 Gy over 5 weeks) with modified XELOX regimen (oxaliplatin dose reduction to 100 mg/m(2)), and total mesorectal excision. Tumor response, toxicities, and surgical complications were recorded.
  
  
  RESULTS
  Forty-two patients treated with the strategy were identified. All patients completed planned dose of induction chemotherapy and concurrent chemoradiotherapy. Grade 3 toxicities were thrombocytopenia (4.8%), diarrhea (7.1%), proctitis (4.8%), and radiation dermatitis (7.1%). Five patients (12.5%) developed postoperative complications. Pathologic complete response (pCR) and nearly pCR were achieved in 7 (15.0%) and 13 patients (35.0%).
  
  
  CONCLUSIONS
  The preliminary results suggest that induction chemotherapy followed by chemoradiotherapy with capecitabine and oxaliplatin in LARC is well tolerated. The strategy achieves favorable short term outcome in terms of pCR and nearly pCR rate, which warrants further investigation.
authors.affiliation: State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.
authors.forename: Yuan-Hong
authors.initials: YH
authors.lastname: Gao
authors.forename: Xin
authors.initials: X
authors.lastname: An
authors.forename: Wei-Jiang
authors.initials: WJ
authors.lastname: Sun
authors.forename: Juan
authors.initials: J
authors.lastname: Cai
authors.forename: Mu-Yan
authors.initials: MY
authors.lastname: Cai
authors.forename: Ling-Heng
authors.initials: LH
authors.lastname: Kong
authors.forename: Jun-Zhong
authors.initials: JZ
authors.lastname: Lin
authors.forename: Guo-Chen
authors.initials: GC
authors.lastname: Liu
authors.forename: Jing-Hua
authors.initials: JH
authors.lastname: Tang
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Wu
authors.forename: Gong
authors.initials: G
authors.lastname: Chen
authors.forename: Zhi-Zhong
authors.initials: ZZ
authors.lastname: Pan
authors.forename: Pei-Rong
authors.initials: PR
authors.lastname: Ding
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects*; D000069287:Capecitabine; D059248:Chemoradiotherapy; D002681:China; D016208:Databases, Factual; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D003967:Diarrhea / Q000209:etiology; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D006801:Humans; D060828:Induction Chemotherapy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D000077150:Oxaliplatin; D011349:Proctitis / Q000209:etiology; D011855:Radiodermatitis / Q000209:etiology; D012004:Rectal Neoplasms / Q000473:pathology / Q000628:therapy*; D012074:Remission Induction; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil
keywords: capecitabine; chemoradiotherapy; induction chemotherapy; oxaliplatin; rectal cancer