The Impact of Capecitabine and Oxaliplatin in the Neoadjuvant Treatment for Patients with  Locally Advanced Rectal Cancer

Marwa I.Abdelgawad; Amal Ryan; Ahmed Soluiman; Gehan S. Seifeldein

Volume : VI, Issue : I, January - 2016

The Impact of Capecitabine and Oxaliplatin in the Neoadjuvant Treatment for Patients with Locally Advanced Rectal Cancer

Marwa I. Abdelgawad, Amal Ryan, Ahmed Soluiman, Gehan S. Seifeldein

Abstract :

Background:Colorectal cancer (CRC) is one of cancer–related mortality in digestive system.Egypt has early onset colorectal cancers allover the world, and few studies designed to understand this cancer. Objectives: Primary: evaluate curative effects and safety of addition of oxaliplatin to preoperative oral fluoropyrimidine–based chemoradiation (CRT) improves 2–year Local Control in locally advanced rectal cancer. Secondary : determine 2–year progression–free survival (PFS),2–year overall survival and toxicity of this neoadjuvant regimen . Patients and Methods: 33 patients were randomly assigned to preoperative CT–RT with CAPOX (50.4–Gy RT for 5 weeks with concurrent capecitabine and oxaliplatin). Patients underwent preoperative Pelvic high resolution MRI or abdominal and pelvic MDCT scans for restaging of middle and lower thirds cancer. Thereafter Sphincter –Preserving Surgery performed after 6 weeks . statistical methods: p–values less than 0.05 were considered significant. SPSS ver.21 for Windows (SPSS Inc., Chicago, IL, USA). Results: 18 patients (54.5%) achieved complete response to neoadjuvant therapy , 8(24.2%) achieved partial response, and 7 (21.3%) had stable disease. The overall accuracy of MRI/MDCT restaging was 66.7% and 78.8% respectively.Sphincter –Preserving Surgery performed in 27 patients (81.8%),6 patients ( 18.2%) underwent abdominoperineal resection. Mean overall survival(Mean ± S.D) is (11.00 ±8.18) months and reported 60.6% local control rate and39.4%local failure rate after follow up period of 24 months. Disease free survival(Mean ± S.D) is 9.25±6.37. Conclusions:At 2 years, there is significant difference in clinical outcome achieved with the CAPOX regimen.These results indicate that neoadjuvant concurrent administration of oxaliplatin and capecitabine with RT could change the course of management.