Adjuvant CCRT for locally advanced rectal cancer: Uracil-tegafur? Or intravenous fluorouracil?

Abstract

13582 Background: This prospective, nonrandomized study was conducted to compare the efficacy and toxicity of postoperative concurrent chemoradiation therapy (CCRT) using daily oral uracil-tegafur plus leucovorin (UFUR/LV) vs. weekly intravenous fluorouracil plus leucovorin (5-FU/LV) in patients with locally advanced rectal cancer. Methods: From November 1996 through December 2004, 30 patients with stage II or III rectal cancer were enrolled. Seventeen received oral UFUR/LV regiment and thirteen with intravenous 5-FU/LV regiment during CCRT. A weekly infusion of 400 to 450 mg/m2 of 5-FU plus a bolus injection of 80 to 100 mg/m2 of LV and 250 to 300 mg/m2/d of oral UFUR plus 30 to 45 mg /m2/d of oral LV were given separately during RT and for an additional 42 weeks thereafter. Forty-five Gy of whole-pelvis irradiation was followed by a local boost of 5.4 to 14.4 Gy to the tumor bed delivered in 33 fractions. Analytical method was Kaplan-Meier method. Results: Mean survival in the UFUR/LV group was 36 months compare with 30 months in the 5-FU/LV group. The 2-year OS, DFS and LCR were 68.1% vs. 65.8%, 54.9% vs. 50.4%, and 79.4% vs. 83.9%, (p > 0.05), respectively. There were no treatment-related deaths and grade 4 toxicity in both groups. Grade 3 of dermatitis, gastrointestinal, and hematologic toxicity was noted in the 5-FU/LV group. Conclusions: Postoperative CCRT with oral UFUR/LV in locally advanced rectal cancer provides an alternative way for those who have difficulty with an intravenous regimen due to it was more tolerable and less toxicity and has similar survival rate. No significant financial relationships to disclose.