my personal edition > radiation oncology > news


  E-Mail this DGDispatch to a colleague

DGDispatch

Chemotherapy Plus Radiation Better in Preventing Local Recurrence of Rectal Cancer: Presented at ASTRO

By Ed Susman

DENVER, CO -- October 21, 2005 -- In a study designed 13 years ago, researchers determined that pre-surgery chemotherapy and radiation provides rectal cancer patients with better local control of disease.

"The standard treatment for rectal cancer has been radiation therapy alone before surgery," said Pascale Romestaing, MD, Chief, Radiotherapy Service, Centre Hospitalier Universitaire Lyon Sud, Lyon, France, "but this it the first randomized study to prove that adding chemotherapy to the treatment helps patients beat their cancer."

The study enrolled patients with adenocarcinoma of the rectum, believed to be resectable at Stage 3-4 without metastases. In one group of 363 patients, treatment was the then standard radiation alone, which consisted of 45 Gray in 25 fractions over a 5-week period. A second group of 370 patients were treated with radiation and chemotherapy with concurrent IV bolus 5-fluorouracil 350 mg/m² and leucovorin 20 mg/m² on days 1 to 5 on weeks 1 and 5.

Dr. Romestaing presented her results in a plenary symposium on October 17^th at the 47^th annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

The 5-year local recurrence rate in the patients given radiotherapy alone was 16.5% compared to 8% in the patients on dual therapy. That difference was considered statistically significant at the P < .001 level.

Theodore Lawrence, MD, Professor and Chief of Radiation Oncology, University of Michigan School of Medicine, Ann Arbor, Michigan, United States, commented, "Prevention of local recurrence is extremely important in this disease,"

"When this disease recurs patients suffer terrible pain and their quality of life is diminished," Dr. Lawrence said.

Dr. Romestaing said the study did not show an overall survival benefit; nor did preoperative chemotherapy allow for more sphincter-saving surgery. However, the combination treatment resulted in a significant increase in Grade 3-4 toxicities.

Since the study was begun more than a decade ago, Dr. Romestaing noted that other drugs have been developed -- notably oxaliplatin -- that appear to be even more active in preventing recurrence. Clinical trial with that drug and others are under way.


[Presentation title: Preoperative Chemoradiotherapy (CT-RT) Improves Local Control in T3-4 Rectal Cancers: Results of the FFCD 9203 Randomized Trial. Abstract 4]

E-Mail this DGDispatch to a colleague

To print, use this version