TY - JOUR
T1 - Neoadjuvant chemoradiotherapy with 5-fluorouracil by bolus
AU - Pasetto, Lara Maria
AU - Sinigaglia, Giulietta
AU - Basso, Umberto
AU - Cocchio, Silvia
AU - Compostella, Alessia
AU - Pucciarelli, Salvatore
AU - Friso, Maria Luisa
AU - Rugge, Massimo
AU - Toppan, Paola
AU - Agostini, Marco
AU - Monfardini, Silvio
N1 - Copyright:
Copyright 2009 Elsevier B.V., All rights reserved.
PY - 2008/11
Y1 - 2008/11
N2 - Background: Neoadjuvant chemoradiotherapy (CT-RT) with continuous infusion (c.i.) 5-fluorouracil (5-FU) before resection of high-risk rectal cancer improves overall survival (OS) and pelvic control. Since the presence of cardiomiopathy may contraindicate c.i. of 5-FU, an alternative regimen of 5-FU CT-RT was prospectively studied in these patients. Patients and Methods: From October 2000 to December 2006, patients with clinical stage T3 or T4, or node-positive disease were assigned according to their cardiological status to receive weekly 5-FU bolus administration during radiotherapy (RT). The preoperative treatment consisted of 5,040 cGy, delivered infractions of 180 cGy per day, five days per week, and 5-FU, given in 15 minutes at a dose of 450 mg/m2 of body surface area weekly during all radiotherapy. Surgery was performed six weeks after the completion of CT-RT. The primary endpoint was disease-free survival (DFS). Results: Fifty-one patients received preoperative CH-RT. The 2-year OS rate was 92.3% and the 3-year DFS was 87.5%. The five-year cumulative incidence of local relapse was 3.9%. Grade 3 acute toxic effects occurred in 19.6% of the patients; worsening of patient's cardiopathy was never reported. Conclusion: Patients with cardiopathy developed similar local control and DFS, toxicity and OS with 5-FU administered weekly by bolus as those reported by literature data.
AB - Background: Neoadjuvant chemoradiotherapy (CT-RT) with continuous infusion (c.i.) 5-fluorouracil (5-FU) before resection of high-risk rectal cancer improves overall survival (OS) and pelvic control. Since the presence of cardiomiopathy may contraindicate c.i. of 5-FU, an alternative regimen of 5-FU CT-RT was prospectively studied in these patients. Patients and Methods: From October 2000 to December 2006, patients with clinical stage T3 or T4, or node-positive disease were assigned according to their cardiological status to receive weekly 5-FU bolus administration during radiotherapy (RT). The preoperative treatment consisted of 5,040 cGy, delivered infractions of 180 cGy per day, five days per week, and 5-FU, given in 15 minutes at a dose of 450 mg/m2 of body surface area weekly during all radiotherapy. Surgery was performed six weeks after the completion of CT-RT. The primary endpoint was disease-free survival (DFS). Results: Fifty-one patients received preoperative CH-RT. The 2-year OS rate was 92.3% and the 3-year DFS was 87.5%. The five-year cumulative incidence of local relapse was 3.9%. Grade 3 acute toxic effects occurred in 19.6% of the patients; worsening of patient's cardiopathy was never reported. Conclusion: Patients with cardiopathy developed similar local control and DFS, toxicity and OS with 5-FU administered weekly by bolus as those reported by literature data.
KW - Bolus 5-fluorouracil
KW - Cardiotoxicity
KW - Neoadjuvant chemotherapy
KW - Rectal cancer
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M3 - Article
C2 - 19192666
AN - SCOPUS:58149161999
VL - 28
SP - 4095
EP - 4100
JO - Anticancer Research
JF - Anticancer Research
SN - 0250-7005
IS - 6 B
ER -