J Cancer 2018; 9(8):1365-1370. doi:10.7150/jca.23874

Research Paper

Long-Term Outcome of Oxaliplatin and Capecitabine (XELOX) Concomitant with Neoadjuvant Radiotherapy and Extended to the Resting Period in High Risk Locally Advanced Rectal Cancer

Jinghua Tang1,2*, Xiaojun Wu1,2*, Yanfang Bai1,3, Yuanhong Gao1,4, Wu Jiang1,2, Lingheng Kong1,2, Junzhong Lin1,2, Desen Wan1,2, Zhizhong Pan1,2✉, Peirong Ding1,2✉

1. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, P R. China;
2. Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
3. Department of Anesthesiology & Operating Theatre, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
4. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
*Jinghua Tang and Xiaojun Wu contributed equally to this article.

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Citation:
Tang J, Wu X, Bai Y, Gao Y, Jiang W, Kong L, Lin J, Wan D, Pan Z, Ding P. Long-Term Outcome of Oxaliplatin and Capecitabine (XELOX) Concomitant with Neoadjuvant Radiotherapy and Extended to the Resting Period in High Risk Locally Advanced Rectal Cancer. J Cancer 2018; 9(8):1365-1370. doi:10.7150/jca.23874. Available from http://www.jcancer.org/v09p1365.htm

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Abstract

Purpose: 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).

Methods: 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.

Results: 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).

Conclusion: 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.

Keywords: Rectal Cancer, Chemoradiotherapy, Oxaliplatin, Capecitabine, Long-term Survival