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Ikeda M, Sekimoto M, Fukunaga Y, Konishi K, Fujiwara Y, Mizushima T, Takemasa I, Yamamoto H, Doki Y, Mori M. A phase I study of oral UFT/leucovorin and irinotecan, plus radiation for locally recurrent rectal cancer. JOURNAL OF THE ANUS RECTUM AND COLON 2018; 1:50-55. [PMID: 31583301 PMCID: PMC6768668 DOI: 10.23922/jarc.2016-009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 03/02/2017] [Indexed: 11/30/2022]
Abstract
Objectives: The aim of this phase I study is to identify the maximum tolerated dose (MTD) and recommended dose (RD) of CPT-11 in combination with UFT/LV and radiation in patients with locally recurrent rectal cancer. Methods: Patients with histologically proven rectal cancer with local recurrence were eligible for this study. Escalating doses of CPT-11 (30-60 mg/m2) were administered on days 3, 10, 24, and 31. UFT (300 mg/m2) and LV (75 mg/body) were given on days 1-5, 8-12, 22-26, and 29-33. Radiotherapy doses consisted of 50 Gy in daily fractions of 2.0 Gy each, 5 times per week, for total 5 weeks. Results: We recruited 27 patients, and the MTD of CPT-11 was 60 mg/m2 due to the occurrence of dose-limiting toxicity of grade 3 diarrhea. Major grade 3 adverse events were neutropenia (5/27; 18.5%) and diarrhea (6/27; 22.2%). No grade 4 adverse event was observed throughout this treatment. Conclusions: The combined chemoradiotherapy with oral UFT/LV plus CPT-11 is feasible and promising. The recommended dose for further phase II trials is determined to be 50 mg/m2 of CPT-11.
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Affiliation(s)
- Masataka Ikeda
- Department of Surgery, Osaka National Hospital, Osaka, Japan
| | | | - Yosuke Fukunaga
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Tokyo, Japan
| | - Koji Konishi
- Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Yushi Fujiwara
- Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Tsunekazu Mizushima
- Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Ichiro Takemasa
- Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Hirofumi Yamamoto
- Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Yuichiro Doki
- Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Masaki Mori
- Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
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Choi HJ, Kim NK, Keum KC, Cheon SH, Shin SJ, Baik SH, Choen JH, Rha SY, Roh JK, Jeung HC, Chung HC, Ahn JB. Phase I trial of neoadjuvant concurrent chemoradiotherapy with S-1 and weekly irinotecan in locally advanced rectal cancer. Radiother Oncol 2008; 87:361-6. [DOI: 10.1016/j.radonc.2008.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Revised: 03/14/2008] [Accepted: 04/01/2008] [Indexed: 11/25/2022]
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Casado E, Pfeiffer P, Feliu J, González-Barón M, Vestermark L, Jensen HA. UFT (tegafur-uracil) in rectal cancer. Ann Oncol 2008; 19:1371-1378. [PMID: 18381370 DOI: 10.1093/annonc/mdn067] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Major achievements in the treatment of localised rectal cancer include the development of total mesorectal excision and the perioperative administration of radiotherapy in combination with continuous infusion (CI) 5-fluorouracil (5-FU). This multimodal approach has resulted in extended survival and lower local relapse rates, with the potential for sphincter-preserving procedures. However, CI 5-FU is inconvenient for patients and is costly. Oral fluoropyrimidines like UFT (tegafur-uracil) offer a number of advantages over 5-FU. METHODS We undertook a review of published articles and abstracts relating to clinical studies of UFT in the treatment of locally advanced rectal cancer (LARC). Pre- and postoperative studies carried out in patients with newly diagnosed or recurrent disease were included. RESULTS The combination of UFT and radiotherapy was effective and well tolerated in the preoperative setting, while adjuvant UFT improved survival and reduced distant relapse compared with surgery alone. The efficacy of UFT appears comparable with that of 5-FU and capecitabine and its side-effect profile is favourable. CONCLUSION Clinical experience to date suggests that UFT is a valuable treatment option for the perioperative treatment of LARC. Further improvements in patient outcomes may result from the combination of UFT with targeted agents.
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Affiliation(s)
- E Casado
- Department of Medical Oncology, Hospital Infanta Sofía, Madrid, Spain.
| | - P Pfeiffer
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - J Feliu
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
| | - M González-Barón
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
| | - L Vestermark
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - H A Jensen
- Department of Oncology, Odense University Hospital, Odense, Denmark
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