Neoadjuvant treatment for locally advanced XXXX with concomitant radiotherapy and oral @entity416 .

@entity1 @entity137 @entity416 @entity5 @entity294 @entity343 @entity189 @entity420 @entity188 @entity1909 @entity1210
PURPOSE: Concomitant chemoradiotherapy prior to surgery of locally advanced @entity189 (clinical T3- 4, and/or N+) might improve the therapeutic results. We report on our clinical experience with 34 @entity1 receiving concurrent preoperative radiotherapy and @entity416 . @entity1 AND METHODS: Between September 2001 and March 2003, 34 @entity1 with a median age of 62 years (range 18-75 years) were treated for @entity188 . @entity416 was administered orally at a dose of 825 mg/m(2) twice-daily concomitantly every day during pelvic irradiation. The planned total dose of radiotherapy was 50.4 Gy, given with daily fractions of 1.8Gy, 5 days a week, over a period of about 5.5 weeks. Large pelvic dose ( @entity343 -1) was 45.0 Gy/25 fractions in 5 weeks. Higher dose up to 50.4 Gy in further 3 fractions was given using boost fields ( @entity343 -2). Radiotherapy was performed with high-energy photon beam (18 MV) linear accelerator using 3-dimensional (3D) treatment planning for 3 or 4 fields technique. RESULTS: @entity137 was low: grade (G) 3 local @entity1909 (6%), G3 @entity294 in 3 (9%) and G3 @entity1210 in 1 (3%) @entity1 . However, 2(6%) @entity1 required drug dose reduction by 80%. Sphincter-sparing surgery was possible in 25 (76.5%) @entity1 while 9 (26%) @entity1 had radical surgery with removal of all macroscopic disease. Tumor mass downstaging by TNM criteria has been achieved in all of the treated @entity1 . Pathological (p) complete response (CR) was verified in 7 (21%) @entity1 and minimal @entity5 was found in 6 (17%) @entity1 , for a total of 13 (38%) @entity1 with substantial disease remission. CONCLUSION: Preoperative concomitant radiotherapy and oral @entity416 chemotherapy for locally advanced @entity420 appears to be an effective and safe therapeutic choice, improving the chance for rectal-sparing surgery. The follow-up time is rather short to evaluate time to progression and survival.
