Archives of Medical Research
Volume 37, Issue 7 , Pages 860-865, October 2006

5-Fluorouracil and Weekly Oxaliplatin Combined with Radiotherapy for Locally Advanced Rectal Cancer: Surgical Complications and Long-term Results

  • Salvatore Pucciarelli

      Affiliations

    • Clinica Chirurgica II, Dipartimento di Scienze Oncologiche e Chirurgiche, Padova, Italy
    • Corresponding Author InformationAddress reprint requests to: Salvatore Pucciarelli, M.D., Dipartimento di Scienze Oncologiche e Chirurgiche, Sezione di Clinica Chirurgica II, Policlinico, VI piano, Via Giustiniani, 2, 35128 Padova Italy
  • ,
  • Emanuele Urso

      Affiliations

    • Clinica Chirurgica II, Dipartimento di Scienze Oncologiche e Chirurgiche, Padova, Italy
  • ,
  • Gian Luca DeSalvo

      Affiliations

    • Servizio Sperimentazioni Cliniche e Biostatistica, Istituto Oncologico Veneto, Padova, Italy
  • ,
  • Carlo Aschele

      Affiliations

    • Oncologia Medica, Ospedale Galliera di Genova, Genova, Italy
  • ,
  • Maria Luisa Friso

      Affiliations

    • Divisione di Radioterapia, Azienda Ospedaliera, Padova, Italy
  • ,
  • Massimo Rugge

      Affiliations

    • Istituto di Anatomia Patologica, Padova, Italy
  • ,
  • Paola Toppan

      Affiliations

    • Clinica Chirurgica II, Dipartimento di Scienze Oncologiche e Chirurgiche, Padova, Italy
  • ,
  • Andrea Bruttocao

      Affiliations

    • Chirurgia Geriatrica, Padova, Italy
  • ,
  • Giuliano Fabris

      Affiliations

    • Chirurgia Generale, Azienda Ospedaliera, Padova, Italy
  • ,
  • Benito Ferraro

      Affiliations

    • U.O. di Chirurgia, Ospedale San Antonio, Padova, Italy
  • ,
  • Sara Lonardi

      Affiliations

    • Divisione di Oncologia Medica, Azienda Ospedaliera, Padova, Italy
  • ,
  • Mauro Frego

      Affiliations

    • Clinica Chirurgica I, Padova, Italy
  • ,
  • Cristiano Finco

      Affiliations

    • Clinica Chirurgica III University of Padova, Padova, Italy
  • ,
  • Mario Lise

      Affiliations

    • Clinica Chirurgica II, Dipartimento di Scienze Oncologiche e Chirurgiche, Padova, Italy
  • ,
  • Donato Nitti

      Affiliations

    • Clinica Chirurgica II, Dipartimento di Scienze Oncologiche e Chirurgiche, Padova, Italy

Received 11 August 2005; accepted 3 April 2006.

(ARCMED-D-05-00307)

Background

We undertook this study to evaluate early surgical complications and long-term results after preoperative radiotherapy and chemotherapy (RCT) using 5-fluorouracil (5-FU) and oxaliplatin (OXA) for rectal cancer.

Methods

Forty six TNM stage II–III rectal cancer patients were studied, who were given preoperative RT (50.4 Gy/28 fractions) combined with 5-FU (200–225 mg/m2/day by continuous venous infusion) and weekly OXA (25–60 mg/m2). Major complications and reoperations were recorded overall, whereas outcome analyses were performed only for patients who received the recommended regimen dosage.

Results

Forty three patients (M:F, 25:18; median age 59 years) were available for analysis. All patients received the planned RT dose. There were no postoperative deaths; seven patients had early major surgical complications, four requiring re-operation. One additional patient had a second surgical procedure due to a duodenal fistula complicating the resection of an aortic aneurysm performed concomitantly with rectal cancer surgery. At a median follow-up of 49 months, two of the 23 patients treated at the recommended doses developed recurrence (one local, and one local and distant), and two died of cancer progression. Following the Kaplan-Meier method, the estimated 5-year overall and disease-free survival rates were 92 and 89%, respectively.

Conclusions

The preoperative RCT regimen used in the present study incurs a low rate of recurrence with an acceptable surgical morbidity.

Key Words: Rectal cancer, Chemotherapy, Radiotherapy, Adjuvant treatment, Complications, Outcome

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PII: S0188-4409(06)00164-0

doi:10.1016/j.arcmed.2006.04.008

Archives of Medical Research
Volume 37, Issue 7 , Pages 860-865, October 2006