International Journal of Radiation Oncology * Biology * Physics
Volume 49, Issue 4 , Pages 987-995 , 15 March 2001

Preoperative combined modality therapy for clinically resectable uT3 rectal adenocarcinoma

Presented at the 36th Annual Meeting of the American Society of Clinical Oncology.

  • Alison Grann, M.D.

      Affiliations

    • Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
    • ,
  • Cynthia Feng, B.S.

      Affiliations

    • Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
    • ,
  • Douglas Wong, M.D.

      Affiliations

    • Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
    • ,
  • Leonard Saltz, M.D.

      Affiliations

    • Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
    • ,
  • Philip P Paty, M.D.

      Affiliations

    • Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
    • ,
  • Jose G Guillem, M.D.

      Affiliations

    • Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
    • ,
  • Alfred M Cohen, M.D.

      Affiliations

    • Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
    • ,
  • Bruce D Minsky, M.D.

      Affiliations

    • Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
    • Corresponding Author InformationReprint requests to: Bruce D. Minsky, M.D., Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., NY, NY 10021. Tel: (212) 639-6817; Fax: (212) 639-8876

,Accepted 20 October 2000.

References 

  1. O’Connell MJ, Martenson JA, Weiand HS, et al.  Improving adjuvant therapy for rectal cancer by combining protracted infusion fluorouracil with radiation therapy after curative surgery. N Engl J Med. 1994;331:502–507
  2. Krook JE, Moertel CG, Gunderson LL, et al.  Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med. 1991;324:709–715
  3. Douglass HO, Moertel CG, Mayer RJ, et al.  Survival after postoperative combination treatment of rectal cancer. N Engl J Med. 1986;315:1294–1295
  4. Fisher B, Wolmark N, Rockette H, et al.  Postoperative adjuvant chemotherapy or radiation therapy for rectal cancer (Results from NSABP protocol R-01). J Natl Cancer Inst. 1988;80:21–29
  5. Wolmark N, Weiand HS, Hyams DM, et al.  Randomized trial of postoperative adjuvant chemotherapy with or without radiotherapy for carcinoma of the rectum (National Surgical Adjuvant Breast and Bowel Project protocol R-02). J Natl Cancer Inst. 2000;92:388–396
  6. Grann A, Minsky BD, Cohen AM, et al.  Preliminary results of pre-operative 5-Fluorouracil (5-FU), low dose leucovorin, and concurrent radiation therapy for resectable T3 rectal cancer. Dis Colon Rectum. 1997;40:515–522
  7. Grann A, Feng C, Wong D; et al. Pre-op combined modality therapy (CMT) for uT3 rectal cancer. Proc ASCO 2000;19:249a(Abstr.)
  8. Minsky BD, Cohen AM, Enker WE, et al.  Pre-operative 5-FU, low dose leucovorin, and concurrent radiation therapy for rectal cancer. Cancer. 1993;73:273–278
  9. Minsky BD. Pelvic radiation therapy in rectal cancer (Technical considerations). Sem Radiat Oncol. 1993;3:42–47
  10. Alekitar KM, Zelefsky MJ, Paty PB, et al.  High dose rate intraoperative brachytherapy for recurrent colorectal cancer. Int J Radiat Oncol Biol Phys. 2000;48:219–226
  11. Minsky BD, Kemeny N, Cohen AM, et al.  Preoperative high-dose leucovorin/5-fluorouracil and radiation therapy for unresectable rectal cancer. Cancer. 1991;67:2859–2866
  12. Wagman R, Minsky BD, Cohen AM, Guillem JG, Paty PB. Sphincter preservation with preoperative radiation therapy and coloanal anastomosis (Long term follow-up). Int J Radiat Oncol Biol Phys. 1998;42:51–57
  13. Kaplan EL, Meier P. Nonparametric estimation for incomplete observation. J Am Stat Assoc. 1958;53:457–481
  14. Bosset JF, Magnin V, Maingon P, et al.  Preoperative radiochemotherapy in rectal cancer (Long-term results of a phase II trial). Int J Radiat Oncol Biol Phys. 2000;46:323–327
  15. Valentini V, Coco C, Cellini N, et al.  Preoperative chemoradiation with cisplatin and 5-fluorouracil for extraperitoneal T3 rectal cancer (Acute toxicity, tumor response, sphincter preservation). Int J Radiat Oncol Biol Phys. 1999;45:1175–1184
  16. Brown T, Janjan NA, Feig BW; et al. Improved overall survival among responders to preoperative chemoradiation for locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 1999;45s:339(Abstr.).
  17. Janjan NA, Khoo VS, Abbruzzese J, et al.  Tumor downstaging and sphincter preservation with preoperative chemoradiation in locally advanced rectal cancer (The M.D. Anderson Cancer Center experience). Int J Radiat Oncol Biol Phys. 1999;44:1027–1038
  18. Bozzetti F, Baratti D, Andreola S, et al.  Preoperative radiation therapy for patients with T2-T3 carcinoma of the middle-to-lower rectum. Cancer. 1999;86:398–404
  19. Myerson RJ, Genovesi D, Lockett MA, et al.  Five fractions of preoperative radiotherapy for selected cases of rectal carcinoma (Long-term tumor control and tolerance to treatment). Int J Radiat Oncol Biol Phys. 1999;43:537–543
  20. Minsky BD. Primary treatment of rectal cancer (Present and future). Crit Rev Onc Heme. 1999;32:19–30
  21. Enker WE, Merchant N, Cohen AM, et al.  Safety and efficacy of low anterior resection for rectal cancer. 681 consecutive cases from a speciality service. Ann Surg. 1999;230:544–554
  22. Francois Y, Nemoz CJ, Baulieux J, et al.  Influence of the interval between preoperative radiation therapy and surgery on downstaging and on the rate of sphincter-sparing surgery for rectal cancer (The Lyon R90-01 randomized trial). J Clin Oncol. 1999;17:2396–2402
  23. Swedish Rectal Cancer Trial. Improved survival with preoperative radiotherapy in resectable rectal cancer. N Engl J Med 1997;336:980–987.
  24. Holm T, Rutqvist LE, Johansson H, Cedermark B. Postoperative mortality in rectal cancer treated with or without preoperative radiotherapy (Causes and risk factors). Br J Surg. 1996;83:964–968
  25. Holm T, Singnomklao T, Rutqvist LE, Cedermark B. Adjuvant preoperative radiotherapy in patients with rectal carcinoma. Adverse effects during long term follow-up of two randomized trials. Cancer. 1996;78:968–976
  26. Hyams DM, Mamounas EP, Petrelli N, et al.  A clinical trial to evaluate the worth of preoperative multimodality therapy in patients with operable carcinoma of the rectum. A progress report of the National Surgical Adjuvant Breast and Bowel Project protocol R0-3. Dis Colon Rectum. 1997;40:131–139
  27. Mohiuddin M, Regine WF, Marks GJ, Marks JW. High-dose preoperative radiation and the challenge of sphincter-preservation surgery for cancer of the distal 2 cm of the rectum. Int J Radiat Oncol Biol Phys. 1998;40:569–574
  28. Minsky BD, Cohen AM, Enker WE, Paty P. Sphincter preservation with preoperative radiation therapy and coloanal anastomosis. Int J Radiat Oncol Biol Phys. 1995;31:553–559
  29. Pucciarelli S, Toppan P, Friso ML, et al.  Preoperative combined radiotherapy and chemotherapy for rectal cancer does not affect early postoperative morbidity and mortality in low anterior resection. Dis Colon Rectum. 1999;42:1278–1284
  30. Graf W, Dahlberg M, Osman MM, Holmberg L, Pahlman L, Glimelius B. Short-term preoperative radiotherapy results in down-staging of rectal cancer (A study of 1316 patients). Radiother Oncol. 1997;43:133–137
  31. Minsky BD, O’Reilly E, Wong D, et al.  Daily low-dose irinotecan (CPT-11) plus pelvic irradiation as preoperative treatment of locally advanced rectal cancer. Proc ASCO. 1999;18:266a;(Abstr.)
  32. Mitchell E, Ahmad N, Fry RD, et al.  Combined modality therapy of locally advanced or recurrent adenocarcinoma of the rectum (Preliminary report of a phase I trial of chemotherapy (CT) with CPT-11, 5-FU, and concomitant irradiation (RT)). Proc ASCO. 1999;18:247a;(Abstr.)
  33. Botwood N, James R, Vernon C, Price P. A phase I study of “Tomudex” (raltitrexed) with radiotherapy (RT) as adjuvant treatment in patients (pt) with operable rectal cancer. Proc ASCO 1998;17:277a(Abstr.).
  34. James RD, Price P, Valentini V. Raltitrexed (Tomudex) concomitant with radiotherapy as adjuvant treatment for patients with rectal cancer (Preliminary results of phase I studies). Eur J Cancer. 1999;35:s19–s22
  35. Valentini V, Morganti AG, Fiorentino G, et al.  Chemoradiation with raltitrexed (Tomudex) and concomitant preoperative radiotherapy has potential in the treatment of stage II/III resectable rectal cancer. Proc ASCO. 1999;18:257a;(Abstr.)
  36. James RD, Price P, Smith M. Raltitrexed (Tomudex) plus radiotherapy is well tolerated and warrants further investigation in patients with advanced inoperable/recurrent rectal cancer. Proc ASCO. 1999;18:288a;(Abstr.)
  37. Feliu J, Calvillo J, Escribano A, et al.  Neoadjuvant therapy of rectal carcinoma with UFT-folinic acid (LV) plus radiotherapy. Proc ASCO. 1999;18:239a;(Abstr.)
  38. Pfeiffer P. Concurrent UFT/L-leucovorin and curative intended radiotherapy (60 Gy) in patients with locally advanced rectal cancer (LARC) (A phase I/II trial). Proc ASCO. 2000;19:255a;(Abstr.)
  39. Anne P, Mitchell EP, Ahmad N, et al.  Radiosensitization in locally advanced adenocarcinoma of the rectum using combined modality therapy (CMT) with CPT-11, 5-fluorouracil, concomitant irradiation. Proc ASCO. 2000;19:250aw;(Abstr.)
  40. Carraro S, Roca E, Cartelli C, et al.  Oxaliplatin (OXA), 5-florouracil (5-FU), and leucovorin (LV) plus radiotherapy in unresectable rectal cancer (URC) (preliminary results). Proc ASCO. 2000;19:291a;(Abstr.)
  41. Freyer G, Bossard N, Romestaing P, Mornex F, Trillet-Lenoir V, Gerard JP. Oxaliplatin (OXA), 5-fluorouracil (5-FU), L-folinic acid (FA), and concomitant irradiation in patients with rectal cancer (A phase I study). Proc ASCO. 2000;19:260a;(Abstr.)
  42. Glynne-Jones R, Falk S, Maughan T, Sebag-Montefiore D, Meadows HM, Das-Gupta A. Results of preoperative radiation and oxaliplatin in combination with 5-fluorouracil (5-FU) and leucovorin (LV). Proc ASCO. 2000;19:310a;(Abstr.)
  43. Cohen DP, Lee CG, Anscher MS, et al.  Phase I study of chemoradiation therapy with oral Eniluracil (776C85)/5-fluorouracil in patients with rectal adenocarcinoma. Proc ASCO. 2000;19:261a;(Abstr.)
  44. Dunst J, Reese T, Frings S. Phase I study of Capecitabine combined with standard radiotherapy in patients with rectal cancer. Proc ASCO. 2000;19:256a;(Abstr.)
  45. Ahmad NR, Nagle DA, Topham A. Pathologic complete response predicts long-term survival following preoperative radiation therapy for rectal cancer. Int J Radiat Oncol Biol Phys. 1997;39:284;(Abstr.)
  46. Habr-Gama A, Santinho B, de Souza PM, Ribeiro U, et al.  Low rectal cancer. Impact of radiation and chemotherapy on surgical treatment. Dis Colon Rectum. 1998;41:1087–1096
  47. Nicholl ID, Dunlop MG. Molecular markers of prognosis in colorectal cancer. J Natl Cancer Inst. 1999;91:1267–1269
  48. Rich TA. Infusional chemoradiation for operable rectal cancer (Post-, pre-, or nonoperative management?). Oncology. 1997;11:295–315
  49. Berger C, de Muret A, Garaud P, et al.  Preoperative radiotherapy (RT) for rectal cancer (predictive factors of tumor downstaging and residual tumor density (RTCD): prognostic implications). Int J Radiat Oncol Biol Phys. 1997;37:619–627
  50. Willett CG, Hagan M, Daley W, Warland G, Shellito PC, Compton CC. Changes in tumor proliferation of rectal cancer induced by preoperative 5-fluorouracil and irradiation. Dis Colon Rectum. 1998;41:62–67
  51. Rouanet P, Fabre JM, Dubois JB, et al.  Conservative surgery for low rectal carcinoma after high-dose radiation. Functional and oncologic results. Ann Surg. 1995;221:67–73
  52. Maghfoor I, Wilkes J, Kuvshinoff B, et al.  Neoadjuvant chemoradiotherapy with sphincter-sparing surgery for low lying rectal cancer. Proc ASCO. 1997;16:274;(Abstr.)
  53. Valentini V, Coco C, Cellini N, et al.  Preoperative chemoradiation for extraperitoneal T3 rectal cancer (Acute toxicity, tumor response, and sphincter preservation). Int J Radiat Oncol Biol Phys. 1998;40:1067–1075

PII: S0360-3016(00)01529-7

doi: 10.1016/S0360-3016(00)01529-7

International Journal of Radiation Oncology * Biology * Physics
Volume 49, Issue 4 , Pages 987-995 , 15 March 2001

Article Tools

* Image Usage & Resolution