Saudi Journal of Gastroenterology
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Year : 2014  |  Volume : 20  |  Issue : 2  |  Page : 102-107

Preoperative chemoradiation in locally advanced rectal cancer: A comparison of bolus 5-fluorouracil/leucovorin and capecitabine

1 Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
2 Okmeydani Training and Research Hospital, Istanbul, Turkey

Correspondence Address:
Adnan Yoney
Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-3767.129474

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Purpose: To compare the acute toxicities, pathologic response, surgical margins, downstaging, local control, disease-free survival (DFS), and overall survival (OS) in locally advanced rectal cancer patients with preoperative radiotherapy (RT) with either concurrent bolus 5-fluorouracil (5-FU)/leucovorin (LV) or capecitabine (CA). Materials and Methods: Sixty patients who presented to our department with a diagnosis of locally advanced rectal cancer were treated with surgery following preoperative RT with either concurrent 5-FU/LV or CA between January 2008 and December 2011 were analyzed. Results: Median follow-up period was 38 months (range 3-61). Four patients (6.7%) had grade 3 gastrointestinal (GIS) toxicity during the course of chemoradiotherapy. The pathologic complete response rates were 8% with 5-FU/LV and 8.6% with CA (P = 0.844). Also, 60% of the patients treated with 5-FU/LV and 37.1% with CA had downstaging of the T stage after chemoradiotherapy (P = 0.026). The 5-year local control (P = 0.510), distant control (P = 0.721), DFS (P = 0.08), and OS (P = 0.09) rates were 80%, 80%, 59.4%, and 64.4%, respectively, for patients treated with 5-FU/LV and 85.7%, 82.9%, 74.8%, and 75.1%, respectively, for patients treated with CA. Conclusion: No significant differences were seen in the local control and distant recurrences and the survival among patients treated with pre-op RT and concurrent 5-FU/LV compared with those treated with pre-op RT and concurrent CA, except toxicities.

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