title: Evaluation of Preoperative Chemotherapy with Modified OPTIMOX-1 Plus Bevacizumab in Patients with Advanced Rectal Cancer with Factors Contraindicative of Curative Surgery.
abstract: OBJECTIVE
  The efficacy and safety of neoadjuvant chemotherapy in patients with highly advanced rectal cancer for whom radical surgery was considered difficult were evaluated.
  
  
  METHODS
  From June 2007 to February 2011, 10 advanced lower rectal cancer patients with factors contraindicative of curative surgery with total mesenteric excision were eligible for this study. Neoadjuvant chemotherapy consisting of modified OPTIMOX1 (mFOLFOX6 and sLV5FU2 alternating administration) plus bevacizumab was administered.
  
  
  RESULTS
  Adverse events seen with chemotherapy consisted of grade 2 leukopenia in 1 patient, but there were no cases of delayed administration or dosage reduction due to grade 2 neurotoxicity. The surgical procedures were anus-preserving resection in 8 patients, total pelvic exenteration in 1 patient, and posterior pelvic exenteration in 1 patient. A positive radial margin was confirmed in 3 patients, but radical surgery was performed, histologically as well, in the other patients. Upon comparing the clinical and postoperative histological stages, primary tumor and node downstaging was achieved in 20.0% and 70.0% of the patients, respectively.
  
  
  CONCLUSIONS
  These findings suggest the potential utility of neoadjuvant chemotherapy consisting of modified OPTIMOX1 plus bevacizumab prior to permitting radical resection or anus-preserving surgery in patients with highly advanced rectal cancer.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Kosugi
authors.forename: Keiji
authors.initials: K
authors.lastname: Koda
authors.forename: Kuniya
authors.initials: K
authors.lastname: Tanaka
authors.forename: Masato
authors.initials: M
authors.lastname: Suzuki
authors.forename: Masato
authors.initials: M
authors.lastname: Yamazaki
authors.forename: Kiyohiko
authors.initials: K
authors.lastname: Shuto
authors.forename: Kenichi
authors.initials: K
authors.lastname: Matsuo
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirano
authors.forename: Hidehito
authors.initials: H
authors.lastname: Arimitsu
authors.forename: Risa
authors.initials: R
authors.lastname: Shiragami
authors.forename: Hideki
authors.initials: H
authors.lastname: Yasuda
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage; D015331:Cohort Studies; D013505:Digestive System Surgical Procedures; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D012007:Rectum / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil