Comparison of concurrent chemoradiotherapy with capecitabine and oxaliplatin versus capecitabine alone in stage Ⅱ/Ⅲ rectal cancer patients after radical operation
Feng Yanru, Jin Jing, Wang Xin, Xiao Qin, Wang Weihu, Wang Shulian, Liu Yueping, Song Yongwen, Ren Hua, Fang Hui, Li Ning, Li Yexiong, Liu Xinfan, Yu Zihao
Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China
Abstract：Objective To compare the efficacy of concurrent chemoradiotherapy (CCRT) with capecitabine and oxaliplatin versus capecitabine alone in stage Ⅱ/Ⅲ rectal cancer patients after radical operation. Methods A retrospective analysis was performed on the clinical data of 675 patients with stage Ⅱ/Ⅲ rectal cancer who received postoperative concurrent chemoradiotherapy (CCRT) with capecitabine (CAP group, n=427) or capecitabine and oxaliplatin (CAPOX group, n=248) from 2002 to 2010. The treatment modality was total mesorectal excision+CCRT±adjuvant chemotherapy. Radiotherapy was delivered to the true pelvis at a dose of 45.0—50.4 Gy/25 fractions. Results The propensity score matching method (1∶1) was applied to balance the baseline characteristics and assign 248 patients to each group. The 5-year sample sizes for CAP group and CAPOX group were 81,104. There were no significant differences between the two groups in 5-year overall survival (78.1% vs. 74.9%, P=0.547), disease-free survival (74.4% vs. 67.9%, P=0.292), locoregional control (94.5% vs. 92.8%, P=0.484), and distant metastasis-free survival (77.1% vs. 70.9%, P=0.364). But grade 3/4 toxicities occurred in24.6% of patients in the CAP group, versus 38.3% in the CAPOX group (P=0.001). Conclusions CCRT with oxaliplatin and capecitabine has no survival advantage over CCRT with capecitabine alone and increases the incidence of toxicities in stage Ⅱ/Ⅲ rectal cancer patients after radical operation. CCRT with capecitabine alone is still the standard regimen.
. Comparison of concurrent chemoradiotherapy with capecitabine and oxaliplatin versus capecitabine alone in stage Ⅱ/Ⅲ rectal cancer patients after radical operation[J]. Chinese Journal of Radiation Oncology, 2014, 23(3): 199-204.
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