open access

Vol 25, No 6 (2020)
Original research articles
Published online: 2020-11-01
Submitted: 2020-06-26
Get Citation

Neoadjuvant chemotherapy with or without oxaliplatin after short-course radiotherapy in high-risk rectal cancer: A subgroup analysis from a prospective study

Ewa Kosakowska, Lucyna Pietrzak, Wojciech Michalski, Lucyna Kepka, Wojciech Polkowski, Malgorzata Jankiewicz, Bogumila Cisel, Jacek Krynski, Jacek Zwolinski, Lucjan Wyrwicz, Andrzej Rutkowski, Roman Stylinski, Grzegorz Nawrocki, Rafal Sopylo, Marek Szczepkowski, Wieslaw Tarnowski, Krzysztof Bujko
DOI: 10.1016/j.rpor.2020.08.002
·
Rep Pract Oncol Radiother 2020;25(6):1017-1022.

open access

Vol 25, No 6 (2020)
Original research articles
Published online: 2020-11-01
Submitted: 2020-06-26

Abstract

Aim

To evaluate the role of oxaliplatin in neoadjuvant chemotherapy delivered after short-course irradiation.

Background

Using oxaliplatin in the above setting is uncertain.

Patients and methods

A subgroup of 136 patients managed by short-course radiotherapy and 3 cycles of consolidation chemotherapy within the framework of a randomised study was included in this post-hoc analysis. Sixty-seven patients received FOLFOX4 (oxaliplatin group) while oxaliplatin was omitted in the second period of accrual in 69 patients because of protocol amendment (fluorouracil-only group).

Results

Grade 3+ acute toxicity from neoadjuvant treatment was observed in 30% of patients in the oxaliplatin group vs. 16% in the fluorouracil-only group (p=0.053). The corresponding proportions of patients having radical surgery or achieving complete pathological response were 72% vs. 77% (odds ratio [OR]=0.88; 95% confidence interval [CI]: 0.39–1.98; p=0.75) and 15% vs. 7% (OR=2.25; 95% CI: 0.83–6.94; p=0.16), respectively. The long-term outcomes were similar in the two groups. Overall and disease-free survival rates at 5 years were 63% vs. 56% (p=0.78) and 49% vs. 44% (p=0.59), respectively. The corresponding numbers for cumulative incidence of local failure or distant metastases were 33% vs. 38% (hazard ratio [HR]=0.89; 95% CI: 0.52–1.52; p=0.68) and 33% vs. 33% (HR=0.78; 95% CI: 0.43–1.40; p=0.41), respectively.

Conclusion

Our findings do not support adding oxaliplatin to three cycles of chemotherapy delivered after short-course irradiation.

Abstract

Aim

To evaluate the role of oxaliplatin in neoadjuvant chemotherapy delivered after short-course irradiation.

Background

Using oxaliplatin in the above setting is uncertain.

Patients and methods

A subgroup of 136 patients managed by short-course radiotherapy and 3 cycles of consolidation chemotherapy within the framework of a randomised study was included in this post-hoc analysis. Sixty-seven patients received FOLFOX4 (oxaliplatin group) while oxaliplatin was omitted in the second period of accrual in 69 patients because of protocol amendment (fluorouracil-only group).

Results

Grade 3+ acute toxicity from neoadjuvant treatment was observed in 30% of patients in the oxaliplatin group vs. 16% in the fluorouracil-only group (p=0.053). The corresponding proportions of patients having radical surgery or achieving complete pathological response were 72% vs. 77% (odds ratio [OR]=0.88; 95% confidence interval [CI]: 0.39–1.98; p=0.75) and 15% vs. 7% (OR=2.25; 95% CI: 0.83–6.94; p=0.16), respectively. The long-term outcomes were similar in the two groups. Overall and disease-free survival rates at 5 years were 63% vs. 56% (p=0.78) and 49% vs. 44% (p=0.59), respectively. The corresponding numbers for cumulative incidence of local failure or distant metastases were 33% vs. 38% (hazard ratio [HR]=0.89; 95% CI: 0.52–1.52; p=0.68) and 33% vs. 33% (HR=0.78; 95% CI: 0.43–1.40; p=0.41), respectively.

Conclusion

Our findings do not support adding oxaliplatin to three cycles of chemotherapy delivered after short-course irradiation.

Get Citation

Keywords

Rectal cancer; Neoadjuvant chemotherapy; Oxaliplatin

About this article
Title

Neoadjuvant chemotherapy with or without oxaliplatin after short-course radiotherapy in high-risk rectal cancer: A subgroup analysis from a prospective study

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 25, No 6 (2020)

Pages

1017-1022

Published online

2020-11-01

DOI

10.1016/j.rpor.2020.08.002

Bibliographic record

Rep Pract Oncol Radiother 2020;25(6):1017-1022.

Keywords

Rectal cancer
Neoadjuvant chemotherapy
Oxaliplatin

Authors

Ewa Kosakowska
Lucyna Pietrzak
Wojciech Michalski
Lucyna Kepka
Wojciech Polkowski
Malgorzata Jankiewicz
Bogumila Cisel
Jacek Krynski
Jacek Zwolinski
Lucjan Wyrwicz
Andrzej Rutkowski
Roman Stylinski
Grzegorz Nawrocki
Rafal Sopylo
Marek Szczepkowski
Wieslaw Tarnowski
Krzysztof Bujko

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