Yerushalmi Rinat, Idelevich Efraim, Dror Ygael, Stemmer Salomon M, Figer Arie, Sulkes Aaron, Brenner Baruch, Loven David, Dreznik Zeev, Nudelman Israel, Shani Adi, Fenig Eyal
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Surg Oncol. 2006 Jun 1;93(7):529-33. doi: 10.1002/jso.20503.
We compared the efficacy and toxicity of oral capecitabine and continuous infusion of 5-fluorouracil (5-FU) in the preoperative chemoradiation treatment of patients with rectal cancer.
The files of 89 patients with rectal cancer, 43 treated preoperatively with oral capecitabine and 46 with intravenous 5-FU, were reviewed, and the outcome of the groups was compared.
There was no statistically significant difference in the complete pathological response rate between the capecitabine and the 5-FU groups (30% vs. 17%, P = 0.15). The downstaging rate was higher in the capecitabine group (77% vs. 50%, P = 0.009). Toxicity was mild in both groups. The rate of Grade 3 gastrointestinal toxicity was similar in the two groups (diarrhea 2% vs. 4%, proctitis 5% vs. 7%), except for one patient in the 5-FU group (2%) who developed a rectovaginal fistula. In the capecitabine group, one patient (2%) had Grade 3 hand-foot syndrome, and another had an acute myocardial infarction. In the 5-FU group, two patients (4%) had Grade 3 hematological toxicity, and three (6%) had complications from Port-a-Cath insertion.
Preoperative chemoradiation with oral capecitabine appears to be safe and well tolerated, and at least as good as continuous 5-FU.
我们比较了口服卡培他滨和持续输注5-氟尿嘧啶（5-FU）在直肠癌患者术前放化疗中的疗效和毒性。
回顾了89例直肠癌患者的病历，其中43例术前接受口服卡培他滨治疗，46例接受静脉注射5-FU治疗，并比较了两组的治疗结果。
卡培他滨组和5-FU组的完全病理缓解率无统计学显著差异（30%对17%，P = 0.15）。卡培他滨组的降期率更高（77%对50%，P = 0.009）。两组的毒性均较轻。两组3级胃肠道毒性发生率相似（腹泻2%对4%，直肠炎5%对7%），但5-FU组有1例患者（2%）发生直肠阴道瘘。在卡培他滨组，1例患者（2%）出现3级手足综合征，另1例发生急性心肌梗死。在5-FU组，2例患者（4%）出现3级血液学毒性，3例（6%）发生经皮中心静脉导管插入术相关并发症。
口服卡培他滨进行术前放化疗似乎安全且耐受性良好，至少与持续输注5-FU效果相当。
