الفهرس | Only 14 pages are availabe for public view |
Abstract To evaluate the safety and efficacy of neoadjuvant chemoradiation containing oxaliplatin in locally advanced cancer rectum. Patients and Methods : A prospective, single arm, phase II study, done on 40 patients of locally advanced (T3, T4, N+) cancer rectum from June 2013 to June 2015. Patients received 2 full courses of induction FOLFOX4 chemotherapy, followed by concomitant chemoradiotherapy (CRT) consisted of oxaliplatin 100 mg/m2 D1,29of RT, folinic acid 20 mg/m2 D1, 29, and 5FU 300 mg/ m2 D1: 5, 29: 33 continuous infusion (during the 1st and 5th week of RT), with 3D conformal pelvic RT 45 Gy by conventional fractionation. Surgery was done 4 - 6 weeks after end of the chemo-radiotherapy course. Adjuvant treatment consisted of 2 months FOLFOX4 chemotherapy. Booster dose RT 9 Gy/5 fractions was added in cases with positive margin or persistent T4 tumors after surgery.Results: 95% of the patients ended neo-adjuvant CRT course with 75% received full treatment doses. Overall response occurred in 86% of patients; 16% of them showed pathological complete response (pCR), initial failure occurred in 5% only of patients, sphincter sparing surgery (SSS) was done in 43% of patients. CRT course passed with tolerable and reversible toxicity;grade III toxicity occurred in 10% only of patients,and no grade IV toxicity reported.Conclusion: Adding oxaliplatin to neoadjuvant CRT in locally advanced cancer rectum cases was feasible, tolerable, with satisfactory response rates,thus encouraging more studies with larger number of patients and longer follow up periods. |