PMID- 20472346
OWN - NLM
STAT- MEDLINE
DCOM- 20110311
LR  - 20220330
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 79
IP  - 3
DP  - 2011 Mar 1
TI  - Oxaliplatin plus dual inhibition of thymidilate synthase during preoperative 
      pelvic radiotherapy for locally advanced rectal carcinoma: long-term outcome.
PG  - 670-6
LID - 10.1016/j.ijrobp.2009.12.007 [doi]
AB  - PURPOSE: To assess the safety and efficacy of oxaliplatin (OXA) plus dual 
      inhibition of thymidilate synthase during preoperative pelvic radiotherapy (RT) 
      in patients with poor prognosis for rectal carcinoma. METHODS AND MATERIALS: 
      Sixty-three patients with the following characteristics, a clinical (c) stage T4, 
      cN1-2, or cT3N0 of </=5 cm from the anal verge and/or with a circumferential 
      resection margin (CRM) of </=5 mm (by magnetic resonance imaging), received three 
      biweekly courses of chemotherapy with OXA, 100 mg/m2; raltitrexed (RTX), 2.5 
      mg/m2 on day 1, and 5-fluorouracil (5-FU), 900 mg/m2 (31 patients) or 800 mg/m2 
      (32 patients); levo-folinic acid (LFA), 250 mg/m2 on day 2, during pelvic RT (45 
      Gy). Pathologic response was defined as complete pathological response (ypCR), 
      major (tumor regression grade(TRG) 2 to 3, with ypCRM-ve and ypN-ve) or minor or 
      no response (TRG4 to -5, or ypCRM+ve, or ypN+ve). Adjuvant 5-FU/LFA regimen was 
      given in cases of cT4, ypN+ve, or ypCRM+ve. RESULTS: Overall, neutropenia (40%) 
      and diarrhea (13%) were the most common grade>/=3 toxicities, and tolerability was 
      better with a 5-FU dose reduction. No significant difference in pathologic 
      response was seen according 5-FU dosage: overall, a ypCR was obtained in 24 (39%) 
      patients, and a major response in 20 (32%) patients. The 5-year probability of 
      freedom from recurrence was 80% (95% confidence interval, 68%-92%); it was 56% 
      for the minor/no response group, while it was around 90% for both the ypCR and 
      the major response group. CONCLUSIONS: OXA, RTX, and 5-FU/LFA administered during 
      pelvic RT produced promising early and long-term results in rectal carcinoma 
      patients with poor prognosis. The postoperative treatment strategy applied in our 
      study supports the risk-adapted approach in postoperative management.
CI  - Copyright (c) 2011 Elsevier Inc. All rights reserved.
FAU - Avallone, Antonio
AU  - Avallone A
AD  - Department of Gastrointestinal Medical Oncology, National Cancer Institute, 
      Naples, Italy. avalloneantonio@libero.it
FAU - Delrio, Paolo
AU  - Delrio P
FAU - Pecori, Biagio
AU  - Pecori B
FAU - Tatangelo, Fabiana
AU  - Tatangelo F
FAU - Petrillo, Antonella
AU  - Petrillo A
FAU - Scott, Nigel
AU  - Scott N
FAU - Marone, Pietro
AU  - Marone P
FAU - Aloi, Luigi
AU  - Aloi L
FAU - Sandomenico, Claudia
AU  - Sandomenico C
FAU - Lastoria, Secondo
AU  - Lastoria S
FAU - Iaffaioli, Vincenzo Rosario
AU  - Iaffaioli VR
FAU - Scala, Dario
AU  - Scala D
FAU - Iodice, Giovanni
AU  - Iodice G
FAU - Budillon, Alfredo
AU  - Budillon A
FAU - Comella, Pasquale
AU  - Comella P
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100514
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
RN  - 0 (Neoplasm Proteins)
RN  - 0 (Organoplatinum Compounds)
RN  - 0 (Quinazolines)
RN  - 0 (Thiophenes)
RN  - 04ZR38536J (Oxaliplatin)
RN  - 12001-76-2 (Vitamin B Complex)
RN  - EC 2.1.1.45 (Thymidylate Synthase)
RN  - FCB9EGG971 (raltitrexed)
RN  - Q573I9DVLP (Leucovorin)
RN  - U3P01618RT (Fluorouracil)
SB  - IM
MH  - Adenocarcinoma/drug therapy/enzymology/pathology/*radiotherapy/surgery
MH  - Adult
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - Combined Modality Therapy/adverse effects/methods
MH  - Diarrhea/etiology
MH  - Female
MH  - Fluorouracil/administration & dosage/adverse effects
MH  - Humans
MH  - Leucovorin/administration & dosage
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Proteins/*antagonists & inhibitors
MH  - Neoplasm Staging
MH  - Neutropenia/etiology
MH  - Organoplatinum Compounds/adverse effects/*therapeutic use
MH  - Oxaliplatin
MH  - Postoperative Complications/pathology
MH  - Preoperative Care/methods
MH  - Prognosis
MH  - Quinazolines/administration & dosage
MH  - Radiotherapy Dosage
MH  - Rectal Neoplasms/drug therapy/enzymology/pathology/*radiotherapy/surgery
MH  - Remission Induction/methods
MH  - Thiophenes/administration & dosage
MH  - Thymidylate Synthase/*antagonists & inhibitors
MH  - Treatment Outcome
MH  - Vitamin B Complex/administration & dosage
EDAT- 2010/05/18 06:00
MHDA- 2011/03/12 06:00
CRDT- 2010/05/18 06:00
PHST- 2009/09/30 00:00 [received]
PHST- 2009/11/28 00:00 [revised]
PHST- 2009/12/01 00:00 [accepted]
PHST- 2010/05/18 06:00 [entrez]
PHST- 2010/05/18 06:00 [pubmed]
PHST- 2011/03/12 06:00 [medline]
AID - S0360-3016(09)03616-5 [pii]
AID - 10.1016/j.ijrobp.2009.12.007 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2011 Mar 1;79(3):670-6. doi: 
      10.1016/j.ijrobp.2009.12.007. Epub 2010 May 14.