To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: ASCO-GI: Radiation Therapy Plus Irinotecan, 5-Fluorouracil, and Folinic Acid Feasible, Effective in Advanced Rectal Cancer URL: http://www.pslgroup.com/dg/249AFE.htm Doctor's Guide January 30, 2005
By Ed Susman HOLLYWOOD, FL -- January 31, 2005 -- Researchers said that combining chemotherapy and radiation in patients with advanced rectal cancer allows for effective disease-free control. After a median follow-up of 18 months, 83% of 24 patients remain disease free, doctors reported here on January 29th at the 2005 Gastrointestinal Cancers Symposium, cosponsored by the American Society of Clinical Oncology, the American Gastroenterological Association, the American Society for Therapeutic Radiology and Oncology, and the Society of Surgical Oncology. "In the adjuvant setting of high-risk rectal cancer, weekly irinotecan, 5-fluorouracil (5-FU), and folinic acid with concurrent pelvic radiation therapy is feasible and effective," said Nikolaos Ziras, MD, medical oncologist, Metaxa Memorial Cancer Hospital, Piraeus, Greece in his poster presentation. Of the 24 patients in the study, there was a 16.7% relapse rate -- 2 patients developed liver metastases and 2 patients experienced local recurrence of cancer. Two of those patients with relapses have died of metastatic disease. "Pelvic radiotherapy plus 5-FU-based chemotherapy is the standard postoperative treatment of stage III rectal cancer," Dr. Ziras noted. "For stage II patients, the adjuvant therapy is controversial, but there is a trend of incorporating such patients in clinical trials." He said that the use of irinotecan to control metastatic colon cancer led to his phase 1 trial designed to find out if irinotecan could be added to the adjuvant regimen and at what dose it would be effective in conjunction with radiation. All of the 24 patients accrued in the study underwent curative surgery for rectal cancer within the 45 days prior to beginning the study and had not received chemotherapy or radiation therapy. They received a total of 45 Gray of radiotherapy to the whole pelvis and a 5.4 Gray boost to the tumor bed. Concomitant chemotherapy was given weekly. The first 6 patients received 350 mg/m2 of 5-FU and 250 mg/m2 of folinic acid; the remaining 18 patients received 250 mg/m2 of 5-FU and 100 mg/m2 of folinic acid. Irinotecan was started at 30 mg/m2 and escalated by steps of 10 mg/m2. Escalation was performed after 3 patients had been monitored without experiencing any dose limiting toxicity. Dr. Ziras determined that 30 mg/m2 is the dose limit of irinotecan when patients are given the higher doses of 5-FU and folinic acid; but irinotecan can be increased to 60 mg/m2 when combined with the lower dose of 5-FU and folinic acid. He said that further studies would attempt to increase the median number of cycles -- 6 in the current study -- to 12 additional weekly chemotherapy cycles. He said the chemoradiation treatment was associated with mild myelosuppression and mild to moderate gastrointestinal toxicity. "This compares well with other studies employing 5-FU and folinic acid with radiotherapy," Dr. Ziras said. "However, caution should be paid to late radiation-induced toxicities which were severe and dose limiting in 3 of the patients." Those toxicities were 2 cases of perianal dermatitis and 1 case of enteritis/colitis. [Presentation title: Postoperative Radiotherapy With Concomitant Weekly CPT-11, 5-Fluorouracil and Folinic Acid in Locally Advanced Rectal Cancer: a Phase I Trial. Abstract 215] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.