The effect of oxaliplatin plus capecitabine in combinafion with preoperative radiation for stage Ⅱ and Ⅲrectal cancer

LONG Cheng; LI Guoquan; JIANG Yongmei

Abstract：Objective To explore the effectiveness and toxicity for patients with stageⅡandⅢrectal cancer after preopera?tive radiation and concurrent oxaliplatin plus capecitabine. Methods A hundred and four patients with histopathologically proven rectal cancer and clinical stageⅡ?Ⅲin the Department of Radiation Oncology of the Second Affiliated Hospital of Dalian Medical Uni?versity from 2008 to 2012 were enrolled in prospective studies. The radiation regimen consisted of 50?4 Gy/28 fractions and the concur?rent chemotherapy was oxaliplatin plus capecitabine,( oxaliplatin 50 mg/m2 per week for 5 times and capecitabine 1650 mg/m2 in bid from d1?d35 ) . Radical surgery was performed 8 weeks after chemoradiotherapy. FOLFOX 6 chemotherapy protocol was given periopera?tively for 6 months. Results The down?staging rate of 104 patients was 55?8%( 58/104) after preoperative chemoradiation. There were 22 cases of CR, 67 cases of PR and 15 cases of SD and the response rate(RR) was 85?6%(89/104). The sphincter preservation rate was 78?8%(82/104). The main adverse reactions were diarrhea, nausea, vomiting, myelosuppression and stomatitis.Only one grade 4 toxicity was observed. No chemoradiation related death was observed. The 3?year overall survival, disease free survival, distant metastasis rate and local recurrence rate for all patients were 90?3%, 74?0%, 24?0%, 3?9%, respectively. Conclusion Delivering oxalipatin plus capecitabine in combination with radiation for stageⅡ andⅢ rectal cancer can bring tumor staging down and increase complete pathological response. The adverse reactions are tolerable for patients and the local control is excellent, but it can?t reduce the distant metastasis rate, which need more follow?up.