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

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