Neoadjuvant hyperfractionated accelerated radiotherapy plus concomitant 5-fluorouracil infusion in locally advanced rectal cancer: A phase. study

dc.contributor.authorGural, Zeynep
dc.contributor.authorSaglam, Sezer
dc.contributor.authorYucel, Serap
dc.contributor.authorKaytan-Saglam, Esra
dc.contributor.authorAsoglu, Oktar
dc.contributor.authorOrdu, Cetin
dc.contributor.authorAcun, Hediye
dc.contributor.authorSharifov, Rasul
dc.contributor.authorOnder, Semen
dc.contributor.authorKizir, Ahmet
dc.contributor.authorOral, Ethem N.
dc.date.accessioned2023-02-21T12:38:47Z
dc.date.available2023-02-21T12:38:47Z
dc.date.issued2018-01-01
dc.description.abstractAIM To evaluate the efficacy and tolerability of neoadjuvant hyperfractionated accelerated radiotherapy (HART) and concurrent chemotherapy in patients with locally advanced infraperitoneal rectal cancer. METHODS A total of 30 patients with histopathologically confirmed T2-3/N0+ infraperitoneal adenocarcinoma of rectum cancer patients received preoperative 42 Gy/1.5 Gy/18 days/bid radiotherapy and continuous infusion of 5-fluorouracil (325 mg/m(2)). All patients were operated 4-8 wk after neoadjuvant concomitant therapy. RESULTS In the early phase of treatment, 6 patients had grade III- IV gastrointestinal toxicity, 2 patients had grade III-IV hematologic toxicity, and 1 patient had grade V toxicity due to postoperative sepsis during chemotherapy. Only 1 patient had radiotherapy-related late side effects, i.e., grade IV tenesmus. Complete pathological response was achieved in 6 patients (21\%), while near-complete pathological response was obtained in 9 (31\%). After a median follow-up period of 60 mo, the local tumor control rate was 96.6\%. In 13 patients, distant metastasis occurred. Disease-free survival rates at 2 and 5 years were 63.3\% and 53\%, and corresponding overall survival rates were 70\% and 53.1\%, respectively. CONCLUSION Although it has excellent local control and complete pathological response rates, neoadjuvant HART concurrent chemotherapy appears to not be a feasible treatment regimen in locally advanced rectal cancer, having high perioperative complication and intolerable side effects. Effects of reduced 5-fluorouracil dose or omission of chemotherapy with the aim of reducing toxicity may be examined in further studies.
dc.description.issue1
dc.description.issueJAN 15
dc.description.pages40-47
dc.description.volume10
dc.identifier.doi10.4251/wjgo.v10.i1.40
dc.identifier.urihttps://hdl.handle.net/11443/2427
dc.identifier.urihttp://dx.doi.org/10.4251/wjgo.v10.i1.40
dc.identifier.wosWOS:000419892600005
dc.publisherBAISHIDENG PUBLISHING GROUP INC
dc.relation.ispartofWORLD JOURNAL OF GASTROINTESTINAL ONCOLOGY
dc.subjectHyperfractionated accelerated radiotherapy
dc.subjectRectal cancer
dc.subjectNeoadjuvant chemoradiotherapy
dc.titleNeoadjuvant hyperfractionated accelerated radiotherapy plus concomitant 5-fluorouracil infusion in locally advanced rectal cancer: A phase. study
dc.typeArticle

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