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. 2017 Oct;14(4):4543-4550.
doi: 10.3892/ol.2017.6764. Epub 2017 Aug 17.

Addition of oxaliplatin to capecitabine-based preoperative chemoradiotherapy for locally advanced rectal cancer: Long-term outcome of a phase II study

Jianhong Peng  1 , Junzhong Lin  1 , Zhifan Zeng  2 , Xiaojun Wu  1 , Gong Chen  1 , Liren Li  1 , Zhenhai Lu  1 , Peirong Ding  1 , Desen Wan  1 , Zhizhong Pan  1
Affiliations

Addition of oxaliplatin to capecitabine-based preoperative chemoradiotherapy for locally advanced rectal cancer: Long-term outcome of a phase II study

Jianhong Peng et al. Oncol Lett. 2017 Oct.

Abstract

Our previous study reported the favorable short-term outcome and good tolerance of integrating oxaliplatin into capecitabine-based (XELOX regimen) preoperative chemoradiotherapy (CRT) for locally advanced rectal cancer (LARC). The present study reported the long-term oncological outcome of this phase II study. A total of 47 patients with rectal adenocarcinoma (stage II or III) were enrolled and received radiotherapy (46 Gy in 23 fractions) in combination with capecitabine (1,000 mg/m2, twice daily, on days 1-14 and 22-35) and oxaliplatin (130 mg/m2 on days 1 and 22). Overall survival (OS) rate, disease-free survival (DFS) rate and cumulative incidence of recurrences and long-term complications were calculated or observed. As a result, 41 patients underwent surgery after preoperative CRT, and the cumulative OS rates at 1, 3 and 5 years for these patients were 100.0, 84.5 and 81.8%, respectively. For the 38 patients who received R0 resection, the cumulative OS rates at 1, 3 and 5 years were 100.0, 89.0 and 86.2%, respectively, while the cumulative DFS rates at 1, 3 and 5 years were 94.6, 75.3 and 69.7%, respectively. After follow-up at 84 months, the cumulative incidence rates of local and distant recurrences at 5 years were 6.6 and 28.2%, respectively. Oxaliplatin-associated long-term complications were seldom observed. Overall, the addition of oxaliplatin to capecitabine-based preoperative radiotherapy achieved favorable OS and DFS without increased long-term complications in patients with LARC. Therefore, this preoperative CRT strategy is a feasible option for such patients.

Keywords: long-term outcome; oxaliplatin; preoperative chemoradiotherapy; rectal cancer.

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Figures

Figure 1.
Figure 1.
Summary of the XELOX phase II study. Of the total 47 patients, 41 patients received surgery for the primary rectal cancer and 38 patients (92.7%) were treated with radical resection of the primary tumor. CRT, chemoradiotherapy; XELOX, capecitabine plus oxaliplatin.
Figure 2.
Figure 2.
Kaplan-Meier curves showing the (A) cumulative incidence of local recurrences and (B) the cumulative incidence of distant recurrences of patients with locally advanced rectal cancer treated by preoperative chemoradiotherapy plus radical resection in the present study.
Figure 3.
Figure 3.
Clinical long-term outcome in patients treated with capecitabine plus oxaliplatin in preoperative chemotherapy. (A) OS in the patients undergoing primary tumor resection (R0 and R2); (B) OS and (C) DFS for patients treated with radical excision surgery following completion of preoperative chemoradiotherapy. OS, overall survival; DFS, disease-free survival.
See this image and copyright information in PMC

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