Neoadjuvant FOLFOX chemotherapy combined with radiotherapy followed by radical resection in patients with locally advanced colon cancer

Chun-Ming Huang, Ming-Yii Huang, Cheng-Jen Ma, Yung -Sung Yeh, Hsiang-Lin Tsai, Ching-Wen Huang, Chih-Jen Huang, Jaw-Yuan Wang, Chun-Ming Huang, Ming-Yii Huang, Cheng-Jen Ma, Yung -Sung Yeh, Hsiang-Lin Tsai, Ching-Wen Huang, Chih-Jen Huang, Jaw-Yuan Wang

Abstract

Background: Patients with locally advanced colon cancer (LACC) have a relatively poor prognosis despite radical resection and adjuvant chemotherapy. This study investigated the treatment efficacy and toxicity of neoadjuvant chemoradiotherapy in patients with LACC.

Methods: We retrospectively reviewed 36 patients with LACC preoperatively treated with chemotherapy and radiotherapy. Patients were administered chemoradiotherapy, which comprised radiotherapy and neoadjuvant chemotherapy involving a 5-fluorouracil, leucovorin, and oxaliplatin regimen every 2 weeks.

Results: Median age was 64 years (45-86 years) and median follow-up period was 23.5 months (5.0-49.1 months). Seven (19.4%) patients developed grade 3 or 4 adverse events during neoadjuvant concurrent chemoradiotherapy. Pathologic responses were not evaluated in two patients who did not undergo radical resection. Of the 34 patients who underwent surgery, nine (26.4%) achieved a pathologic complete response (pCR). The 2-year estimated overall survival and disease-free survival rates were 88.7% and 73.6%, respectively.

Conclusions: Our results demonstrated that neoadjuvant chemoradiotherapy is feasible and safe. A prominent pCR rate with an acceptable toxicity profile suggests that the multimodality therapy might be a treatment option for patients with LACC.

Keywords: Chemoradiotherapy; Colon cancer; Oxaliplatin; Pathologic complete response.

Figures

Fig. 1
Fig. 1
Overall and disease-free survival rates. a Overall survival rate and (b) disease-free survival rate in patients with locally advanced colon cancer receiving neoadjuvant chemoradiation and radical resection

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