A PHASE II TRIAL OF NEOADJUVANT PREOPERATIVE CHEMORADIOTHERAPY WITH S-1 PLUS IRINOTECAN AND RADIATION IN PATIENTS WITH LOCALLY ADVANCED RECTAL CANCER: CLINICAL FEASIBILITY AND RESPONSE RATE

作者：Sato Takeo; Ozawa Heita; Hatate Kazuhiko; Onosato Wataru; Naito Masanori; Nakamura Takatoshi; Ihara Atsushi; Koizumi Wasaburo; Hayakawa Kazushige; Okayasu Isao; Yamashita Keishi; Watanabe Masahiko^*

来源：International Journal of Radiation Oncology, Biology, Physics, 2011, 79(3): 677-683.

DOI：10.1016/j.ijrobp.2009.11.007

• Chemoradiation
• Rectal cancer
• S-1
• Irinotecan

Purpose: We aimed to validate our hypothesis that a preoperative chemoradiotherapy regimen with S-1 plus irinotecan is feasible, safe, and active for the management of locally advanced rectal cancer in a single-arm Phase II setting.
Methods and Materials: Eligible patients had previously untreated, locally advanced rectal adenocarcinoma. Radiotherapy was administered in fractions of 1.8Gy/d for 25 days. S-1 was administered orally in a fixed daily dose of 80mg/m(2) on Days 1 to 5, 8 to 12, 22 to 26, and 29 to 33. Irinotecan (80mg/m(2)) was infused on Days 1, 8, 22, and 29. Four or more weeks after the completion of the treatment, total mesorectal excision with lateral lymph node dissection was performed. The primary endpoint was the rate of completing treatment in terms of feasibility. The secondary endpoints were the response rate and safety.
Results: We enrolled 43 men and 24 women in the study. The number of patients who completed treatment was 58 (86.6%). Overall, 46 patients (68.7%) responded to treatment and 24 (34.7%) had a complete histopathologic response. Three patients had Grade 3 leukopenia, and another three patients had Grade 3 neutropenia. Diarrhea was the most common type of nonhematologic toxicity: 3 patients had Grade 3 diarrhea.
Conclusions: A preoperative regimen of S-1, irinotecan, and radiotherapy to the rectum was feasible, and it appeared safe and effective in this nonrandomized Phase It setting. It exhibited a low incidence of adverse events, a high rate of completion of treatment, and an extremely high rate of pathologic complete response.

• 出版日期2011-3-1