Tang Jinghua, Wu Xiaojun, Bai Yanfang, Gao Yuanhong, Jiang Wu, Kong Lingheng, Lin Junzhong, Wan Desen, Pan Zhizhong, Ding Peirong
Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, P R. China.
Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China.
J Cancer. 2018 Apr 6;9(8):1365-1370. doi: 10.7150/jca.23874. eCollection 2018.
This study aimed at investigating the long-term outcomes of oxaliplatin and capecitabine (XELOX) administered concurrently with preoperative radiation and extended to the resting period in patients with high-risk locally advanced rectal cancer (LARC). From January 2010 to December 2013, 45 patients were recruited. Study treatment consisted two cycles of XELOX regimen concomitant with preoperative radiation and then followed by an additional cycle of XELOX regimen between completion of neoadjuvant radiotherapy and surgery. Disease-free survival (DFS) time and overall survival (OS) time were analyzed. The median follow-up was 51 months. Twelve (26.7%) patients developed local recurrence or distant metastasis, including 10 (22.2%) patients developing distant metastasis only, 1 (2.2%) patient local recurrence only, and 1 (2.2%) patient both local recurrence and distant metastasis. The estimated 3-year DFS and OS was 75.5% (95% CI, 63.0%-88.0%) and 88.6% (95% CI, 98.0%-79.2%), respectively. Receiving adjuvant chemotherapy was a significant predictor for DFS, with hazard ratio 0.24 (95% CI: 0.08-0.74). This intensified strategy with oxaliplatin and capecitabine (XELOX) administered concomitantly with neoadjuvant radiotherapy and then extended to the resting period in high-risk LARC patients is efficient. The long-term outcome is promising. Further study of this strategy is warranted.
本研究旨在调查奥沙利铂和卡培他滨(XELOX方案)与术前放疗同时使用并延长至休息期,对高危局部晚期直肠癌(LARC)患者的长期疗效。2010年1月至2013年12月,共招募了45例患者。研究治疗包括两个周期的XELOX方案与术前放疗同时进行,然后在新辅助放疗完成至手术之间再进行一个周期的XELOX方案。分析无病生存期(DFS)和总生存期(OS)。中位随访时间为51个月。12例(26.7%)患者出现局部复发或远处转移,其中仅10例(22.2%)患者出现远处转移,仅1例(2.2%)患者出现局部复发,1例(2.2%)患者同时出现局部复发和远处转移。估计3年DFS和OS分别为75.5%(95%CI,63.0%-88.0%)和88.6%(95%CI,98.0%-79.2%)。接受辅助化疗是DFS的显著预测因素,风险比为0.24(95%CI:0.08-0.74)。这种奥沙利铂和卡培他滨(XELOX方案)与新辅助放疗同时使用并延长至休息期的强化策略,对高危LARC患者是有效的。长期疗效良好。有必要对该策略进行进一步研究。