Phase II study of preoperative chemoradiotherapy (CRT) with irinotecan plus S-1 in locally advanced rectal cancer

Sang Joon Shin, Namkyu Kim, Ki Chang Keum, Ho Geun Kim, Jun Seok Im, Hye Jin Choi, Seung Hyuk Baik, JaeHee Cheon, Hei Cheul Jeung, SunYoung Rha, Jae Kyung Roh, Hyuncheol Chung, Joong Bae Ahn

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background and purpose: The aim of this study is to evaluate the efficacy and safety of preoperative radiation therapy combined with S-1 and irinotecan (SI) in LARC. Materials and methods: Patients were considered LARC if they had a T3/T4 lesion or node positive. Weekly doses of 40 mg/m2 irinotecan were intravenously administered once per week during weeks 1-5 of radiotherapy. S-1 (70 mg/m2) was given from Monday to Friday in all weeks of radiotherapy. 3-D conformal radiotherapy was given at daily fractions of 1.8 Gy for 5 days for a total dose of 50.4 (45 + 5.4) Gy. Surgery was performed 4-6 weeks following the completion of chemoradiation. Results: Between June 2006 and November 2007, 43 pts were enrolled. The stage was: cT3 24 patients, cT4 6 patients; 28 patients were cN+. Forty-one patients completed the chemoradiation and 42 patients underwent operation: a low anterior resection was performed in 36 patients, a total colectomy in 1 patient, and an abdominal perineal resection in 5 patients. T downstaging was observed in 50%; 23 N+ patients became N- (55%). The complete pathological response was observed in 9 patients (21%). The 3-year locoregional failure rate, distant failure rate, disease-free survival, and overall survival were 9.5%, 18.6%, 72.1%, and 94.3%, respectively. Only three patients experienced G3 diarrhea; one had G3 sepsis and two had septic shock. Hematological toxicity (G3-G4) was observed in five patients. Conclusions: This study demonstrated the efficacy of preoperative CRT with S-1 and irinotecan with 21% of complete response. However, prompt recognition and management of infection is needed to use it in patients with locally advanced rectal cancer.

Original languageEnglish
Pages (from-to)303-307
Number of pages5
JournalRadiotherapy and Oncology
Volume95
Issue number3
DOIs
Publication statusPublished - 2010 Jun 1

Fingerprint

irinotecan
Chemoradiotherapy
Rectal Neoplasms
Radiotherapy

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

Cite this

Shin, Sang Joon ; Kim, Namkyu ; Keum, Ki Chang ; Kim, Ho Geun ; Im, Jun Seok ; Choi, Hye Jin ; Baik, Seung Hyuk ; Cheon, JaeHee ; Jeung, Hei Cheul ; Rha, SunYoung ; Roh, Jae Kyung ; Chung, Hyuncheol ; Ahn, Joong Bae. / Phase II study of preoperative chemoradiotherapy (CRT) with irinotecan plus S-1 in locally advanced rectal cancer. In: Radiotherapy and Oncology. 2010 ; Vol. 95, No. 3. pp. 303-307.
@article{e38ae4350f524568b1fb88e3ffed67a7,
title = "Phase II study of preoperative chemoradiotherapy (CRT) with irinotecan plus S-1 in locally advanced rectal cancer",
abstract = "Background and purpose: The aim of this study is to evaluate the efficacy and safety of preoperative radiation therapy combined with S-1 and irinotecan (SI) in LARC. Materials and methods: Patients were considered LARC if they had a T3/T4 lesion or node positive. Weekly doses of 40 mg/m2 irinotecan were intravenously administered once per week during weeks 1-5 of radiotherapy. S-1 (70 mg/m2) was given from Monday to Friday in all weeks of radiotherapy. 3-D conformal radiotherapy was given at daily fractions of 1.8 Gy for 5 days for a total dose of 50.4 (45 + 5.4) Gy. Surgery was performed 4-6 weeks following the completion of chemoradiation. Results: Between June 2006 and November 2007, 43 pts were enrolled. The stage was: cT3 24 patients, cT4 6 patients; 28 patients were cN+. Forty-one patients completed the chemoradiation and 42 patients underwent operation: a low anterior resection was performed in 36 patients, a total colectomy in 1 patient, and an abdominal perineal resection in 5 patients. T downstaging was observed in 50{\%}; 23 N+ patients became N- (55{\%}). The complete pathological response was observed in 9 patients (21{\%}). The 3-year locoregional failure rate, distant failure rate, disease-free survival, and overall survival were 9.5{\%}, 18.6{\%}, 72.1{\%}, and 94.3{\%}, respectively. Only three patients experienced G3 diarrhea; one had G3 sepsis and two had septic shock. Hematological toxicity (G3-G4) was observed in five patients. Conclusions: This study demonstrated the efficacy of preoperative CRT with S-1 and irinotecan with 21{\%} of complete response. However, prompt recognition and management of infection is needed to use it in patients with locally advanced rectal cancer.",
author = "Shin, {Sang Joon} and Namkyu Kim and Keum, {Ki Chang} and Kim, {Ho Geun} and Im, {Jun Seok} and Choi, {Hye Jin} and Baik, {Seung Hyuk} and JaeHee Cheon and Jeung, {Hei Cheul} and SunYoung Rha and Roh, {Jae Kyung} and Hyuncheol Chung and Ahn, {Joong Bae}",
year = "2010",
month = "6",
day = "1",
doi = "10.1016/j.radonc.2010.02.003",
language = "English",
volume = "95",
pages = "303--307",
journal = "Radiotherapy and Oncology",
issn = "0167-8140",
publisher = "Elsevier Ireland Ltd",
number = "3",

}

Phase II study of preoperative chemoradiotherapy (CRT) with irinotecan plus S-1 in locally advanced rectal cancer. / Shin, Sang Joon; Kim, Namkyu; Keum, Ki Chang; Kim, Ho Geun; Im, Jun Seok; Choi, Hye Jin; Baik, Seung Hyuk; Cheon, JaeHee; Jeung, Hei Cheul; Rha, SunYoung; Roh, Jae Kyung; Chung, Hyuncheol; Ahn, Joong Bae.

In: Radiotherapy and Oncology, Vol. 95, No. 3, 01.06.2010, p. 303-307.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Phase II study of preoperative chemoradiotherapy (CRT) with irinotecan plus S-1 in locally advanced rectal cancer

AU - Shin, Sang Joon

AU - Kim, Namkyu

AU - Keum, Ki Chang

AU - Kim, Ho Geun

AU - Im, Jun Seok

AU - Choi, Hye Jin

AU - Baik, Seung Hyuk

AU - Cheon, JaeHee

AU - Jeung, Hei Cheul

AU - Rha, SunYoung

AU - Roh, Jae Kyung

AU - Chung, Hyuncheol

AU - Ahn, Joong Bae

PY - 2010/6/1

Y1 - 2010/6/1

N2 - Background and purpose: The aim of this study is to evaluate the efficacy and safety of preoperative radiation therapy combined with S-1 and irinotecan (SI) in LARC. Materials and methods: Patients were considered LARC if they had a T3/T4 lesion or node positive. Weekly doses of 40 mg/m2 irinotecan were intravenously administered once per week during weeks 1-5 of radiotherapy. S-1 (70 mg/m2) was given from Monday to Friday in all weeks of radiotherapy. 3-D conformal radiotherapy was given at daily fractions of 1.8 Gy for 5 days for a total dose of 50.4 (45 + 5.4) Gy. Surgery was performed 4-6 weeks following the completion of chemoradiation. Results: Between June 2006 and November 2007, 43 pts were enrolled. The stage was: cT3 24 patients, cT4 6 patients; 28 patients were cN+. Forty-one patients completed the chemoradiation and 42 patients underwent operation: a low anterior resection was performed in 36 patients, a total colectomy in 1 patient, and an abdominal perineal resection in 5 patients. T downstaging was observed in 50%; 23 N+ patients became N- (55%). The complete pathological response was observed in 9 patients (21%). The 3-year locoregional failure rate, distant failure rate, disease-free survival, and overall survival were 9.5%, 18.6%, 72.1%, and 94.3%, respectively. Only three patients experienced G3 diarrhea; one had G3 sepsis and two had septic shock. Hematological toxicity (G3-G4) was observed in five patients. Conclusions: This study demonstrated the efficacy of preoperative CRT with S-1 and irinotecan with 21% of complete response. However, prompt recognition and management of infection is needed to use it in patients with locally advanced rectal cancer.

AB - Background and purpose: The aim of this study is to evaluate the efficacy and safety of preoperative radiation therapy combined with S-1 and irinotecan (SI) in LARC. Materials and methods: Patients were considered LARC if they had a T3/T4 lesion or node positive. Weekly doses of 40 mg/m2 irinotecan were intravenously administered once per week during weeks 1-5 of radiotherapy. S-1 (70 mg/m2) was given from Monday to Friday in all weeks of radiotherapy. 3-D conformal radiotherapy was given at daily fractions of 1.8 Gy for 5 days for a total dose of 50.4 (45 + 5.4) Gy. Surgery was performed 4-6 weeks following the completion of chemoradiation. Results: Between June 2006 and November 2007, 43 pts were enrolled. The stage was: cT3 24 patients, cT4 6 patients; 28 patients were cN+. Forty-one patients completed the chemoradiation and 42 patients underwent operation: a low anterior resection was performed in 36 patients, a total colectomy in 1 patient, and an abdominal perineal resection in 5 patients. T downstaging was observed in 50%; 23 N+ patients became N- (55%). The complete pathological response was observed in 9 patients (21%). The 3-year locoregional failure rate, distant failure rate, disease-free survival, and overall survival were 9.5%, 18.6%, 72.1%, and 94.3%, respectively. Only three patients experienced G3 diarrhea; one had G3 sepsis and two had septic shock. Hematological toxicity (G3-G4) was observed in five patients. Conclusions: This study demonstrated the efficacy of preoperative CRT with S-1 and irinotecan with 21% of complete response. However, prompt recognition and management of infection is needed to use it in patients with locally advanced rectal cancer.

UR - http://www.scopus.com/inward/record.url?scp=77952581386&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77952581386&partnerID=8YFLogxK

U2 - 10.1016/j.radonc.2010.02.003

DO - 10.1016/j.radonc.2010.02.003

M3 - Article

VL - 95

SP - 303

EP - 307

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

SN - 0167-8140

IS - 3

ER -