5-Fluorouracil and Weekly Oxaliplatin Combined with Radiotherapy for Locally Advanced Rectal Cancer: Surgical Complications and Long-term Results
Received 11 August 2005; accepted 3 April 2006.
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.
iDivisione di Oncologia Medica, Azienda Ospedaliera, Padova, Italy
hU.O. di Chirurgia, Ospedale San Antonio, Padova, Italy
Address 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
ABSTRACT