ANALYSIS OF THE RESULTS OF THE XELOX REGIMEN IN PREOPERATIVE CHEMORADIOTHERAPY FOR LOCALLY ADVANCED RECTAL CANCER
Keywords:
locally advanced rectal cancer, oxaliplatin, fluoropyrimidines, preoperative chemoradiotherapy, efficacy, toxicityAbstract
Summary. Objective: a comparative evaluation of the study
of the efficacy and clinical safety of neoadjuvant chemotherapy (NACT) for the use of the XELOX regimen or monochemotherapy with fluoropyrimidine preparations in patients with locally advanced rectal cancer (LARC). Object
and methods: a prospective, randomized, single-centered
study was started in the clinic of the National Cancer Institute. Patients with a clinically radiologic diagnosis were
randomized to a ratio of 1:1. Patients with the main (O)
group (n = 35) performed radiotherapy (RT) with a total
focal dose (TFD) of 50.4Gy (1.8 Gy × 28) and polychemotherapy in XELOX regimen. Patients in the comparison
group (C) (n = 34) performed TFD 50.4 Gy (1.8 Gy × 28)
and monochemotherapy based on preparations of fluoropyrimidine groups. The efficacy of NACT was determined by
QMRT data and by the level of treatment pathomorphism.
The manifestations of chemotherapy toxicity were recorded according to STCAE 4.03 criteria. All patients received
surgical interventions of various types. Results: both groups
achieved statistically identical (p > 0.05) high radicalism
of the operation, although the resection frequency R0 was
slightly higher in patients with the group O — 33 (97.1%)
vs 25 (93.5%) in the group P. R2 resection was not. In both
groups, the most common (58.1–79.4%) were gastrointestinal manifestations of chemotherapy toxicity (I–II degrees).
In the group O, the toxicity of the III and IVdegrees (35.3 vs
19.4%) was recorded more often than in the groupP: in particular, anemia was 2 (5.9%) and 1 (2.9%) vs 1(3.2%) and
1 (3.2%), anorexia — 4 (11.7%) and 0 (0%) vs 3 (9.7%)
and 0 (0%), neurotoxicity — 3 (8,8%) and 2 (5.9%) vs
1 (3.2%) and 0 (0%), respectively, but the differences are
not reliable (p=0.151). Conclusion: oxaliplatin-containing
NACRT (XELOX regimen) with LARC is a safe tactic provided patients are selected in specialized oncological centers.
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