C39
Comparison of capecitabine and intravenous 5-flourouracil with preoperative pelvic radiation for rectal cancer
Vidhyasagar Ramani, Amir Montazeri, Helen Wong, Arthur Sun Myint
Clatterbridge Centre for Oncology, Wirral, UK
Background
Capecitabine provides an attractive alternative option to intravenous (IV) 5-flourouracil (5-FU) in chemoradiation regimes for rectal cancer by avoiding the need for intravenous access and in patient stay.
Aim
To retrospectively compare the efficacy of concurrent capecitabine vs. IV 5-FU in preoperative pelvic chemoradiation schedules for rectal cancer in our centre.
Method
Patients treated from 2005 to 2007 were included in this study. Information was collected on patient characteristics; treatment details; pathological response to treatment; recurrence and survival. All statistical analyses were performed using SPSS V17.
Results
One hundred and six patients were treated with capecitabine and 98 with 5-FU and pelvic radiation. The two groups were well matched for age, sex and TNM stage. There were more PS 0 patients in capecitabine group (53% v 30%) which was statistically significant (p=0.001). Of the 106 patients in the capecitabine group 95 (90%) were able to undergo surgery with 90 (85%) achieving R0 resection. In the 5-FU group 88 (90%) underwent surgery and 70 (80%) were R0. The difference in the rate of R0 resections was statistically significant (p=0.018). The APR rate was 35% in the capecitabine group compared to 47% in the 5-FU group (p=0.024). The pathological complete response (pCR) rates were 14% and 12% in capecitabine and 5-FU groups respectively which was not significant. There was no significant difference in the risk of recurrence between the two groups. The 1and 2 year OS was 92% and 60% for capecitabine group and 82% and 69% for the 5-FU group (p=0.93). The median PFS has not been reached for either group of patients.
Conclusion
Preoperative chemoradiation with capecitabine for rectal cancer is efficacious and comparable to IV 5-FU in this setting.
