Klin Onkol 2003; 16(2): 60-67.
Summary: Preoperative radiotherapy has been proved to improve the outcome in locally advanced undisseminated rectal cancer. The addition of the fluoropyrimidine drug with radiosensitizing effect may further potentiate cytotoxic effect. With this aim capecitabine and concomitant radiotherapy was applied preoperatively to patients with rectal adenocarcinoma, cT3-4, and/or N+ by transrectal sonography, M0. Capecitabine 825 mg/m2 twice daily was given concomitantly with pelvic radiotherapy 1,8 Gy daily up to 45 Gy followed by a boost up to 50,4 Gy. 34 patients (pts), median age 62 years, 24 males, 10 females were treated. Radical resection of residual cancer has been done in 33 pts. The lower rectum (0-5 cm) was affected in 12 pts, the middle rectum (5-10 cm) in 19 and upper rectum (>10 cm) in 3 patients. Rectal amputation was performed in 8 (23,5%) pts, the anus preserving surgery was done in all the others(76,5%). Pathological complete response has been verified in 7(20,6%) pts. Microscopic residuum was found in 6 patients, so there were 13 (38%) pts with substantial remission. Adjuvant chemotherapy with 4 cycles of capecitabine 2500 mg/m2 D1-14 was applied to 13 pts in whose residual tumor pT3-4 or pN+ after surgery were found. The concomitant radiotherapy with capecitabine appears to increase the chance for rectum sparing surgery.
