医学
奥沙利铂
叶酸
卡培他滨
结直肠癌
养生
放化疗
放射治疗
内科学
氟尿嘧啶
相伴的
毒性
外科
肿瘤科
化疗
新辅助治疗
癌症
乳腺癌
作者
Svein Dueland,Anne Hansen Ree,Krystyna Grøholt,Marie Grøn Sælen,Sigurd Folkvord,Knut Håkon Hole,Therese Seierstad,Stein Gunnar Larsen,Karl Erik Giercksky,Johan N. Wiig,Kjetil Boye,Kjersti Flatmark
标识
DOI:10.1016/j.clon.2016.01.014
摘要
Aims This non-randomised study was undertaken to examine oxaliplatin as possibly an intensifying component of sequential neoadjuvant therapy in locally advanced rectal cancer for improved local and metastatic outcome. Materials and methods Ninety-seven patients (57 T2–3 cases, 40 T4 cases) received two cycles of the Nordic FLOX regimen (oxaliplatin 85 mg/m2 day 1 and bolus 5-fluorouracil 500 mg/m2 and folinic acid 100 mg days 1 and 2) before long-course chemoradiotherapy with concomitant oxaliplatin and capecitabine, followed by pelvic surgery. Treatment toxicity, local tumour response and long-term outcome were recorded. Results Good histologic tumour regression was obtained in 72% of patients. Implementing protocol-specific dose adjustments, tolerance was acceptable and 95% of patients received the total prescribed radiation dose. Estimated 5 year progression-free and overall survival were 61% and 83%, respectively. T4 stage was associated with an inferior local response rate, which again was highly associated with impaired long-term outcome. Conclusions In this cohort of rectal cancer patients dominated by T4 and advanced T3 cases given sequential oxaliplatin-containing preoperative therapy with acceptable toxicity, high tumour response rates and overall survival were obtained, consistent with both local and systemic effects. However, tumour response and long-term outcome remained inferior for a significant number of T4 cases, suggesting that the T4 entity is biologically heterogeneous with subgroups of patients eligible for further individualisation of therapy.
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