In a nutshell
Some background
In LARC, the cancer has grown from the rectum (the lowest part of the large bowel) into surrounding tissues and organs, or has spread (metastasized) beyond the bowel. For this type of cancer, treatment includes both surgery to remove the cancer and a combination of chemotherapy and radiotherapy, called CRT. When given before surgery, CRT is given to shrink the cancer or to improve the chances of surgical removal of the cancer, with fewer complications. This is called neoadjuvant CRT. FU (5-fluorouracil or Capecitabine) is a type of chemotherapy often used before surgery in combination with radiation therapy in patients with LARC. Recent studies have shown that the addition of a second chemotherapy drug, OX, was associated with survival benefits in these patients.
Methods & findings
This research reviewed the results of 4 studies and included overall 3863 LARC patients. Along with radiotherapy, patients received two types of chemotherapy treatments before surgery: 49.7% of the patients received an OX/FU combination, while 50.3% of the patients received FU alone. Multiple parameters were evaluated, including decrease in cancer size, metastases and side effects before surgery, as well as complications after surgery.
The authors of the study found that the addition of OX to FU CRT decreased the cancer size by 2.5%. While side effects were by 8.7% more common with the addition of OX, it did not add to the level of complications experienced after surgery. Also, patients treated with the OX/FU CRT had a 2.5% decrease in metastases development compared to patients treated with FU alone.
The bottom line
In summary, the combination of OX/FU CRT decreased cancer size and the risk of developing metastases in patients with LARC. Although patients who received a combination of OX/FU experienced more side effects before surgery compared to patients treated with FU alone, they had similar complication rates after surgery.
Published By :
European journal of cancer
Date :
Oct 11, 2012
