Annals of Coloproctology

Original Articles

A Phase II Study of Additional Four-Week Chemotherapy With Capecitabine During the Resting Periods After Six-Week Neoadjuvant Chemoradiotherapy in Patients With Locally Advanced Rectal Cancer: Kyung Ha Lee, Min Sang Song, Jun Boem Park, Jin Soo Kim, Dae Young Kang, Ji Yeon Kim; Ann Coloproctol. 2013;29(5):192-197. Published online October 31, 2013; DOI: https://doi.org/10.3393/ac.2013.29.5.192

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Purpose

The aim of this study is to evaluate the efficacy and the safety of additional 4-week chemotherapy with capecitabine during the resting periods after a 6-week neoadjuvant chemoradiotherapy (NCRT) in patients with locally advanced rectal cancer.

Methods

Radiotherapy was delivered to the whole pelvis at a total dose of 50.4 Gy for 6 weeks. Oral capecitabine was administered at a dose of 825 mg/m² twice daily for 10 weeks. Surgery was performed 2-4 weeks following the completion of chemotherapy.

Results

Between January 2010 and September 2011, 44 patients were enrolled. Forty-three patients underwent surgery, and 41 patients completed the scheduled treatment. Pathologic complete remission (pCR) was noted in 9 patients (20.9%). T down-staging and N down-staging were observed in 32 patients (74.4%) and 33 patients (76.7%), respectively. Grade 3 to 5 toxicity was noted in 5 patients (11.4%). The pCR rate was similar with the pCR rates obtained after conventional NCRT at our institute and at other institutes.

Conclusion

This study showed that additional 4-week chemotherapy with capecitabine during the resting periods after 6-week NCRT was safe, but it was no more effective than conventional NCRT.

Citations

Citations to this article as recorded by

Locally Advanced Rectal Cancer: What We Learned in the Last Two Decades and the Future Perspectives
Vivek Srivastava, Aakansha Giri Goswami, Somprakas Basu, Vijay Kumar Shukla
Journal of Gastrointestinal Cancer.2023; 54(1): 188. CrossRef
The Effect of Continuing Chemotherapy after Chemoradiotherapy during the Time to Surgery on Tumor Response and Survival for Local Advanced Rectal Cancer
Atike Gökçen Demiray, Arzu Yaren, Uğur Sungurtekin, Papatya Bahar Baltalarlı, Neşe Demirkan, Duygu Herek, Burcu Yapar Taşköylü, Gamze Gököz Doğu, Serkan Değirmencioğlu, Utku Özgen, Halil Sağınç, Umut Çakıroğlu, Nail Özhan, Canan Karan, Burçin Çakan Demire
Journal of Oncology.2022; 2022: 1. CrossRef
Phase 2 Neoadjuvant Treatment Intensification Trials in Rectal Cancer: A Systematic Review
Mark T.W. Teo, Lucy McParland, Ane L. Appelt, David Sebag-Montefiore
International Journal of Radiation Oncology*Biology*Physics.2018; 100(1): 146. CrossRef
Efficacy and Safety of Low-Dose-Rate Endorectal Brachytherapy as a Boost to Neoadjuvant Chemoradiation in the Treatment of Locally Advanced Distal Rectal Cancer: A Phase-II Clinical Trial
Shapour Omidvari, Shadi Zohourinia, Mansour Ansari, Leila Ghahramani, Mohammad Zare-Bandamiri, Ahmad Mosalaei, Niloofar Ahmadloo, Saeedeh Pourahmad, Hamid Nasrolahi, Sayed Hasan Hamedi, Mohammad Mohammadianpanah
Annals of Coloproctology.2015; 31(4): 123. CrossRef
Additional Chemotherapy During Resting Periods After Preoperative Chemoradiotherapy in Patients With Rectal Cancer
Ok Suk Bae
Annals of Coloproctology.2013; 29(5): 178. CrossRef

Oncologic Outcome after Cessation or Dose Reduction of Capecitabine in Patients with Colon Cancer: Jung-A Yun, Hee Cheol Kim, Hyun-Sook Son, Hyoung Ran Kim, Hae Ran Yun, Yong Beom Cho, Seong Hyeon Yun, Woo Yong Lee, Ho-Kyung Chun; J Korean Soc Coloproctol. 2010;26(4):287-292. Published online August 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.4.287

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Abstract PDF

Purpose

Oral capecitabine has been used as adjuvant therapy for colorectal cancer patients since the 1990s. Patient-initiated cessation or reduced use of capecitabine occurs widely for various reasons, yet the consequences of these actions are unclear. The present study sought to clarify treatment outcomes in such patients.

Methods

The study included 173 patients who had been diagnosed with stage II or III colon cancer according to the pathologic report after radical surgery at Samsung Medical Center from May 2005 to June 2007 and who had received capecitabine as adjuvant therapy. The patients were divided into groups according to whether the dose was reduced (I, dose maintenance; II, dose reduction) or stopped (A, cycle completion; B, cycle cessation). Recurrence and disease-free survival rates between the two groups each were analyzed.

Results

Of the 173 patients, 128 (74.6%) experienced complications, most frequently hand-foot syndrome (n = 114). Reduction (n = 35) or cessation (n = 18) of medication was most commonly due to complications. Concerning reduced dosage, both groups displayed no statistically significant differences in recurrence rate and 3-year disease-free survival rate. Concerning discontinued medication use, the cycle completion group showed an improved recurrence rate (P = 0.048) and 3-year disease-free survival rate (P = 0.028).

Conclusion

The results demonstrate that maintaining compliance with capecitabine as an adjuvant treatment for colon cancer to preventing complications positively affects patient prognosis.

Citations

Citations to this article as recorded by

Medication Perceptions Mediate the Association between Illness Perceptions and Adherence to Oral Anticancer Agents among Patients with Gastrointestinal Tract Cancer: A Cross-sectional Study
Yongfeng Chen, Marques Shek Nam Ng, Xulian Wei, LiYuan Zhang, Kai Chow Choi, Yan Ma, Fang Wang, Carmen Wing Han Chan
European Journal of Oncology Nursing.2024; : 102720. CrossRef
The Value of Pharmacogenetics to Reduce Drug-Related Toxicity in Cancer Patients
Doreen Z. Mhandire, Andrew K. L. Goey
Molecular Diagnosis & Therapy.2022; 26(2): 137. CrossRef
Global Cancer Burden and Natural Disasters: A Focus on Asia’s Vulnerability, Resilience Building, and Impact on Cancer Care
Roselle De Guzman, Monica Malik
Journal of Global Oncology.2019; (5): 1. CrossRef
Association Between Adjuvant Chemotherapy Duration and Survival Among Patients With Stage II and III Colon Cancer
Devon J. Boyne, Colleen A. Cuthbert, Dylan E. O’Sullivan, Tolulope T. Sajobi, Robert J. Hilsden, Christine M. Friedenreich, Winson Y. Cheung, Darren R. Brenner
JAMA Network Open.2019; 2(5): e194154. CrossRef
5-fluorouracil Toxicity Mechanism Determination in Human Keratinocytes: in vitro Study on HaCaT Cell Line
Jan Hartinger, Pavel Veselý, Martin Šíma, Irena Netíková, Eva Matoušková, Luboš Petruželka
Prague Medical Report.2017; 118(4): 128. CrossRef
An exploratory study to identify risk factors for the development of capecitabine‐induced Palmar Plantar Erythrodysesthesia (PPE)
Annie Law, Sue Dyson, Denis Anthony
Journal of Advanced Nursing.2015; 71(8): 1825. CrossRef

Capecitabine-based Neoadjuvant Chemoradiation Therapy in Locally-advanced Rectal Cancer.: Choi, Hong Jo , Park, Ki Jae , Lee, Tae Moo , Ha, Sang Sik , Lee, Ho Young , Lee, Hyung Sik; J Korean Soc Coloproctol. 2010;26(2):137-144.; DOI: https://doi.org/10.3393/jksc.2010.26.2.137

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Abstract PDF: PURPOSE
The aim of the study was to evaluate the efficacy and the toxicity of preoperative treatment with capecitabine in combination with radiation therapy (RT) in patients with locally-advanced, resectable rectal cancer.
METHODS
Thirty-five patients with locally-advanced rectal cancer (cT3/4, N-/+) were treated with capecitabine (825 mg/m2, twice daily for 7 days/wk) and concomitant RT (50.4 Gy/28 fractions). Surgery was performed 6-8 wk after completion of the chemoradiation followed by 4-6 cycles of adjuvant capecitabine monotherapy (1,250 mg/m2, twice daily for 14 days every 3 wk).
RESULTS
The chemoradiation program was completed in all but 2 patients, for whom both capecitabine and RT were interrupted for 2 wk because of grade-3 diarrhea. A R0 resection under the principle of total mesorectal excision (low anterior resection, 26; intersphincteric resection, 6; abdominoperineal resection, 2) was performed in all but one patient with a low anterior resection with positive circumferential margin (R1). Primary tumor and node downstaging occurred in 57% and 60% of patients, respectively. The overall rate of downstaging, including both the primary tumor and node, was 77% (27 patients). A pathological complete response of the primary tumor was achieved in 4 patients (11%). No patient had grade-4 toxicity, and the only grade-3 toxicity developed was diarrhea in 2 patients (6%) during chemoradiation. During a median follow-up of 38 mo, distant metastases developed in 4 patients (multiple lung metastases, 2; aortocaval nodal metastases, 2), and another 2 patients showed local recurrence. The three-year disease-free survival was 83%.
CONCLUSION
This study suggests that preoperative capecitabine-based chemoradiation therapy is an effective and safe treatment modality for the tratment of locally-advanced, resectable rectal cancer.

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