Author(s)

Amal Rayan^1*, Hosam A. Hasan², Asmaa M. Zahran³, Ahmed Soliman⁴, Khalid Rezk⁵

¹Clinical Oncology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
²Diagnostic Radiology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
³Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut.
⁴General Surgery Departments, Faculty of medicine, Assiut University, Assiut, Egypt.
⁵Surgical Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.

Aim of work: This study aimed to evaluate the resectability rate, rate of conservative surgery, toxicity, local control, and disease free survival for oxaliplatin and capecitabine based chemoradiation compared to standard 5-FU based chemoradiation in locally advanced cancer rectum. Patients and methods: 65 patients were eligible; 33 patients received oxaliplatin and capecitabine based chemoradiation (arm I) and 32 patients received 5-FU based chemoradiation (arm II). Results: The overall response rate in arms I and II were 78.7% and 87.5% respectively. Conservative surgery was done in 81.81% and 53.13% of patients with arms I and II, pathologic complete response (pCR) rate was significantly better in arm I than arm II (30.3% vs. 21.9%, P < 0.01). 3-year recurrence rates were 54.5% and 56.2% in arms I, II respectively; the median disease free survival (DFS) were 30 months and 15 months in arms I and II respectively. Grade III anemia, grade IV diarrhea and severe proctitis were developed in a significantly large number of patients with arm I; in addition deep venous thrombosis (DVT) was developed in 15.15% of patients with arm I but none in arm II. Conclusion: The addition of oxaliplatin to the preoperative chemo radiation increased the response rate mainly pCR rate which was considered a target goal in the neoadjuvant treatment, but it was not recommended because of higher toxicity and no significant effect on DFS in different response groups of arm I when compared to arm II, but longer follow up may be needed to evaluate the overall survival.

Neoadjuvant Concurrent Chemoradiation, Oxaliplatin, Capecitabine, Locally Advanced Cancer Rectum

Rayan, A. , Hasan, H. , Zahran, A. , Soliman, A. and Rezk, K. (2018) Capecitabine and Oxaliplatin versus 5-Fluorouracil in the Neoadjuvant Chemoradiation for Patients with Locally Advanced Rectal Carcinoma: A Comparative Study. Journal of Cancer Therapy, 9, 767-779. doi: 10.4236/jct.2018.910063.