Postoperative chemoradiotherapy with capecitabine and oxaliplatin vs.capecitabine for pathological stage N2 rectal cancer  

作　　者：Ning Li Yuan Zhu Luying Liu Yanru Feng Wenling Wang Jun Wang Hao Wang Gaofeng Li Yuan Tang Chen Hu Wenyang Liu Hua Ren Shulian Wang Weihu Wang Yongwen Song Yueping Liu Hui Fang Yu Tang Ningning Lu Bo Chen Shunan Qi Yexiong Li Jing Jin 

机构地区：[1]State Key Laboratory of Molecular Oncology,Department of Radiation Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China [2]Department of Radiation Oncology,Cancer Hospital of the University of Chinese Academy of Sciences,Zhejiang Cancer Hospital,Institute of Cancer and Basic Medicine,Chinese Academy of Sciences,Hangzhou 310022,China [3]Department of Radiation Oncology,Guizhou Cancer Hospital,Guiyang 550001,China [4]Department of Radiation Oncology,Tumor Hospital of Hebei Province,Shijiazhuang 050011,China [5]Department of Radiation Oncology,Peking University Third Hospital,Beijing 100034,China [6]Department of Radiation Oncology,Beijing Hospital,Beijing 100730,China [7]Division of Biostatistics and Bioinformatics,Sidney Kimmel Comprehensive Cancer Center,Johns Hopkins University School of Medicine,Baltimore,MD 21205,USA [8]Department of Radiation Oncology,United Family Healthcare,Shenzhen 518038,China [9]Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing),Department of Radiation Oncology,Peking University Cancer Hospital&Institute,Beijing 100142,China [10]Department of Radiation Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital&Shenzhen Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Shenzhen 518116,China

出　　处：《Chinese Journal of Cancer Research》2024年第5期577-586,共10页中国癌症研究（英文版）

基　　金：supported by grants from Sanming Project of Medicine in Shenzhen(No.SZSM202211030);the Science and Technology Department Basic Research Project of Shanxi(No.202203021221284)。

摘　　要：Objective:Several studies have been conducted on the effects and toxicity of adding oxaliplatin to fluorouracilbased or capecitabine-based chemoradiotherapy(CRT)regimens as significantly increasing the toxic response without benefit to survival.In this study,we further explored the role of these two postoperative CRT regimens in patients with pathological stage N2 rectal cancer.Methods:This study was a subgroup analysis of a randomized clinical trial.A total of 180 patients with pathological stage N2 rectal cancer were eligible,85 received capecitabine with radiotherapy(RT),and 95 received capecitabine and oxaliplatin with RT.Patients in both groups received adjuvant chemotherapy[capecitabine and oxaliplatin(XELOX);or fluorouracil,leucovorin,and oxaliplatin(FOLFOX)]after CRT.Results:At a median follow-up of 59.2[interquartile range(IQR),34.0−96.8]months,the three-year diseasefree survival(DFS)was 53.3%and 64.9%in the control group and the experimental group,respectively[hazard ratio(HR),0.63;95%confidence interval(95%CI),0.41−0.98;P=0.04].There was no significant difference between the groups in overall survival(OS)(HR,0.62;95%CI,0.37−1.05;P=0.07),the incidence of locoregional recurrence(HR,0.62;95%CI,0.24−1.64;P=0.33),the incidence of distant metastasis(HR,0.67;95%CI,0.42−1.06;P=0.09)and grade 3−4 acute toxicities(P=0.78).For patients with survival longer than 3 years,the conditional overall survival(COS)was significantly better in the experimental group(HR,0.39;95%CI,0.16−0.96;P=0.03).Conclusions:Our results indicated that adding oxaliplatin to capecitabine-based postoperative CRT is safe and effective in patients with pathological stage N2 rectal cancer.

关 键 词：CHEMORADIOTHERAPY OXALIPLATIN CAPECITABINE rectal neoplasms drug therapy RADIOTHERAPY treatment outcome 

分 类 号：R735.37[医药卫生—肿瘤]