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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 2/2008

01-02-2008 | Original Article

Capecitabine vs continuous infusion 5-FU in neoadjuvant treatment of rectal cancer. A retrospective review

Authors: M. W. Saif, Shahrukh Hashmi, Daniel Zelterman, Khaldoun Almhanna, Richard Kim

Published in: International Journal of Colorectal Disease | Issue 2/2008

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Abstract

Background

Standard therapy for locally advanced rectal cancer (LARC) is concurrent neo-adjuvant chemo-radiation using infusional 5-fluorouracil (CIV-5-FU). Capecitabine (CAP) offers a convenient oral replacement for CIV-5-FU. There is no randomized trial comparing infusional 5-FU to capecitabine. We retrospectively compared the safety and efficacy of CAP-based regimens with well-established CIV-5-FU-based regimens in LARC.

Materials and methods

We collected published data on 542 patients treated on either CIV-5-FU (197) or CAP (345) with concurrent radiation (external radiation treatment, XRT) for LARC. This included Phase I or II studies published or available from Pubmed. Safety was assessed by determining proportion of patients who experienced grade III/IV adverse effects. Efficacy was assessed by determining pathological complete response (pCR). Chi-square tests were used to compare the two regimens. A P value less than 0.05 was considered statistically significant. Statistical tests were further corrected for multiplicity using the method of Benjamini and Yekutieli (Ann Stat, 29(4):1165–1188, 2001).

Results

pCR was significantly higher in patients getting CAP vs CIV-5-FU (25 vs 13%; P = 0.008,.P adj = 0.034). Both regimens were generally well tolerated. There was no grade IV toxicity reported. Grade III hand foot syndrome was more common in the CAP group, and grade III diarrhea was more common in the CIV group.

Conclusions

CAP when compared to CIV seems to have superior efficacy with reasonable toxicities. It is reasonable to treat LARC with CAP + XRT.
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Metadata
Title
Capecitabine vs continuous infusion 5-FU in neoadjuvant treatment of rectal cancer. A retrospective review
Authors
M. W. Saif
Shahrukh Hashmi
Daniel Zelterman
Khaldoun Almhanna
Richard Kim
Publication date
01-02-2008
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 2/2008
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-007-0382-z

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