Safety and efficacy of adjuvant therapy with oxaliplatin, leucovorin and 5-fluorouracil after mesorectal excision with lateral pelvic lymph node dissection for stage iii lower rectal cancer.
OBJECTIVE
Preoperative chemoradiotherapy followed by total mesorectal excision (TME) is the standard treatment for stage III lower rectal cancer worldwide. However, in Japan, the standard treatment is TME with lateral pelvic lymph node dissection (LPLD) followed by adjuvant chemotherapy. We examined the safety and efficacy of adjuvant therapy with oxaliplatin, leucovorin, and 5-fluorouracil (modified FOLFOX6) after TME with LPLD.


METHODS
This retrospective study included 33 patients who received modified FOLFOX6 after TME with LPLD for stage III lower rectal cancer.


RESULTS
The overall completion rate of 12 cycles of adjuvant modified FOLFOX6 was 76%. Grade 3 or 4 neutropenia was observed in eight patients (24%). Sensory neuropathy was observed in 32 patients (97%) with 4 (12%) having a grade 3 event. The disease-free survival (DFS) rate was 45% at 3 years.


CONCLUSIONS
Adjuvant modified FOLFOX6 was feasible in patients with stage III lower rectal cancer after TME with LPLD.
National Cancer Center Hospital, Tokyo, Japan siwasa@ncc.go.jp.
Satoru
S
Iwasa
Chiba Cancer Center, Chiba, Japan.
Hiroaki
H
Souda
Shizuoka Cancer Center, Shizuoka, Japan.
Kentaro
K
Yamazaki
Aichi Cancer Center Hospital, Aichi, Japan.
Daisuke
D
Takahari
Kumamoto University, Kumamoto, Japan.
Yuji
Y
Miyamoto
Niigata Cancer Center Hospital, Niigata, Japan.
Yasumasa
Y
Takii
Hiroshima Prefectural Hospital, Hiroshima, Japan.
Satoshi
S
Ikeda
National Cancer Center Hospital, Tokyo, Japan.
Tetsuya
T
Hamaguchi
National Cancer Center Hospital, Tokyo, Japan.
Yukihide
Y
Kanemitsu
National Cancer Center Hospital, Tokyo, Japan.
Yasuhiro
Y
Shimada
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D000077150:Oxaliplatin; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D012189:Retrospective Studies
D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D002955:Leucovorin; D005472:Fluorouracil
Adjuvant therapy; lateral pelvic lymph node dissection; mesorectal excision; oxaliplatin; rectal cancer