A phase II study of preoperative mFOLFOX6 with short-course radiotherapy in patients with locally advanced rectal cancer and liver-only metastasis

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• 作者：Kyung Hwan Kim^a ; ¹ ; Sang Joon Shin^b ; ¹ ; Min Soo Cho^c ; Joong Bae Ahn^b ; Minkyu Jung^b ; Tae Il Kim^d ; Young Suk Park^e ; Hoguen Kim^f ; Nam Kyu Kim^c ; ^{NAMKYUK@yuhs.ac" class="auth_mail" title="E-mail the corresponding author} ; Woong Sub Koom^a ; ^{mdgold@yuhs.ac" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Short-course radiotherapy ; Rectal cancer ; Metastasis ; Chemotherapy
• 刊名：Radiotherapy and Oncology
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：118
• 期：2
• 页码：369-374
• 全文大小：322 K

文摘

To evaluate the efficacy and safety of upfront mFOLFOX6 followed by short-course radiotherapy (SCRT) and surgery in patients with locally advanced rectal cancer and liver-only metastases.

Materials and methods

This single-arm phase II study involved 32 patients. mFOLFOX6 was administered for four cycles followed by SCRT and another four cycles of mFOLFOX6. Surgery was performed 4–6 weeks after the last chemotherapy cycle. The primary endpoint was complete (R0) resection rate. Secondary endpoints were response rate, progression-free survival (PFS), overall survival (OS), and complication rates.

Results

Surgical resection of the rectum and liver was performed in 25 patients (78%) and R0 resection was achieved in 20 patients (63%). Local tumor downstaging was observed in 54% of patients. Median OS and PFS were 38 and 9 months, respectively. One patient discontinued treatment due to toxicity and no treatment-related deaths occurred. Patients who progressed after 4 cycles of mFOLFOX6 were less likely to receive resection.

Conclusions

This regimen was safe and effective in inducing local tumor response and achieving R0 resection in this patient population.