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AOSOP4 PREOPERATIVE CONCURRENT CAPOX RADIOTHERAPY IN THAI PATIENTS WITH LOCALLY ADVANCED RECTAL CANCER
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Abstracts, 5th AOS and 9th Annual Conference of OOTR, 2013 / European Journal of Cancer 49S1 (2013) S1−S22
Results. Higher sensitivity of diagnosis for HCC with GdEOB-DTPA MRI (88.64%) and Sonazoid-CEUS (84.09%) was observed compared with 64-MDCT (70.45%) for all HCC nodules, albeit insignificantly different. For nodules of 2 cm or less in diameter, compared with 64-MDCT (60.98%), GdEOB-DTPA MRI (82.93%, p < 0.01) and CEUS (78.05%, p < 0.01) had significantly higher diagnostic sensitivity. No significant difference was recorded in diagnostic sensitivity between GdEOB-DTPA MRI and Sonazoid-CEUS (c2 = 0.31, p > 0.05). When nodules were more than 2 cm in diameter, there were no significant differences in diagnostic sensitivity between the imaging modalities. When the combination modality of GdEOB-DTPA and Sonazoid-CEUS was evaluated, the diagnostic sensitivity was increased to 93.5% in HCC nodules of 2 cm or less in diameter. Discussion. Gd-EOB-DTPA and Sonazoid-CEUS for HCC as liverspecific contrast agents showed higher sensitivity of diagnosis compared with 64-MDCT. The combined modality of Gd-EOBDTPA with Sonazoid-CEUS is a better choice for diagnosis of HCC. Funding. Nil. The authors declared no conflicts of interest. AOSOP3 EFFICACY OF CONCURRENT CHEMORADIOTHERAPY WITH CAPECITABINE AND CISPLATIN IN THE MANAGEMENT OF LOCALLY ADVANCED SQUAMOUS CELL CARCINOMA OF THE HEAD AND NECK S. Guptaa *, H. Khana , S. Barika , M.P.S. Negib . a Department of Radiotherapy, King George’s Medical University, Lucknow, Uttar Pradesh, India, b Institute of Data Computing and Training, Lucknow, Uttar Pradesh, India Introduction. We aimed to assess the efficacy and safety of concurrent capecitabine and cisplatin over concurrent cisplatin and fluorouracil in locally advanced squamous cell oral cancer. Methods. We randomly assigned 152 patients (all of whom had stage III or IV unresectable disease and had received two cycles of paclitaxel and cisplatin chemotherapy) to receive either concurrent cisplatin (75 mg/m2 on day 1 and day 2) and fluorouracil (750 mg/m2 on days 1, 2, 3) from the first day of radiotherapy at an interval of 3 weeks or cisplatin (75 mg/m2 on day 1 and day 2) and capecitabine (750 mg/m2 in two divided doses from day 1 to day 14) from the first day of radiotherapy at an interval of 3 weeks. Results. The study showed that the complete response of tumour, node, and overall in arm 1 was significantly higher (p < 0.05 or p < 0.01) compared with arm 2. Further, dose reduction and treatment delay were lowered significantly (p < 0.05 or p < 0.01) in arm 2 compared with arm 1. 3-year disease-free survival (c2 = 0.89, p = 0.346), progression-free survival (c2 = 2.59, p = 0.107), and overall survival (c2 = 1.45, p = 0.229) were similar in the two groups—ie, they did not differ significantly (p > 0.05), although they were 3.00 (hazard ratio (HR) 3.00, 95% confidence interval (CI) 0.30–30.58), 2.34 (HR 2.34, 95% CI 0.83–6.41), and 1.67 (HR 1.67, 95% CI 0.72–3.89) times higher in arm 2 compared with arm 1. The change in haemoglobin, weight, energy level, activity level, and overall quality of life of the two groups during the treatments and at end of the study were compared, showing that the levels of all variables were significantly different and higher in arm 2 compared with arm 1. Treatment-related acute and late
toxicities were similar between the two groups—ie, did not differ significantly (p > 0.05). Discussion. Concurrent chemoradiotherapy with capecitabine and cisplatin was found to be effective and can be regarded as an important regimen assuring the concerns of patients with locally advanced head and neck cancer. Funding. Nil. The authors declared no conflicts of interest. AOSOP4 PREOPERATIVE CONCURRENT CAPOX RADIOTHERAPY IN THAI PATIENTS WITH LOCALLY ADVANCED RECTAL CANCER E. Sirachainana *, C. Sitathaneec , S. Phongkitkarunc , W. Suwanthanmab , N. Larbcharoensubd , N. Trachue , S. Lukraka , K. Sumboonnanondab . a Department of Medicine, b Surgery, c Radiology, d Pathology, and e Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Introduction. The potential advantages of preoperative chemoradiotherapy in rectal cancer include pathological downstaging and reduced toxicity. Capecitabine and fluorouracil showed similar efficacy in preoperative concurrent chemoradiotherapy in locally advanced rectal cancer. Capecitabine in combination with oxaliplatin demonstrated efficacy for advanced colorectal cancer treatment. Methods. We conducted a phase 2 study to determine the efficacy and safety of preoperative concurrent CAPOX radiotherapy in Thai patients with locally advanced rectal cancer. Capecitabine 1650 mg/m2 per day was taken on days 1−14 and 22−35 of radiotherapy. Oxaliplatin 50 mg/m2 was administered on days 1, 8, 22, and 29 of radiotherapy. The radiation dose to the pelvis was 45 Gy/25 fractions with a boost dose of 5.4 Gy/3 fractions. The total dose to the tumour bed was 50.4 Gy/28 fractions. Clinical response was evaluated by MRI prior to surgery. Patients underwent surgery 4−6 weeks after completion of radiotherapy. The endpoints of this study were clinical response, pathological response, and toxicities. Results. Twenty patients have been enrolled. Median age was 59.5 years (range 37−72). Male:female ratio was 1.22:1. All patients had clinical T3 N positive disease except one who hadT4 disease. After receiving concurrent chemoradiotherapy, severe toxicities (diarrhoea, fatigue, anorexia, and neuropathy) were found in four patients (20%). One patient refused surgery after preoperative treatment. Response rate was evaluated in 18 patients. Clinical response rate was 83.4% (cCR 55.6%). Pathological response rate was 70.6% (pCR 5.9%). Eleven patients had microscopic residual disease. Most patients received adjuvant chemotherapy. Two patients developed recurrent disease and finally died. Discussion. Neoadjuvant concurrent capecitabine-oxaliplatin radiotherapy in Thai patients with locally advanced rectal cancer demonstrated excellent response rate and tolerable toxicities. Funding. None declared. The authors declared no conflicts of interest.
Abstracts, 5th AOS and 9th Annual Conference of OOTR, 2013 / European Journal of Cancer 49S1 (2013) S1−S22
Results. Higher sensitivity of diagnosis for HCC with GdEOB-DTPA MRI (88.64%) and Sonazoid-CEUS (84.09%) was observed compared with 64-MDCT (70.45%) for all HCC nodules, albeit insignificantly different. For nodules of 2 cm or less in diameter, compared with 64-MDCT (60.98%), GdEOB-DTPA MRI (82.93%, p < 0.01) and CEUS (78.05%, p < 0.01) had significantly higher diagnostic sensitivity. No significant difference was recorded in diagnostic sensitivity between GdEOB-DTPA MRI and Sonazoid-CEUS (c2 = 0.31, p > 0.05). When nodules were more than 2 cm in diameter, there were no significant differences in diagnostic sensitivity between the imaging modalities. When the combination modality of GdEOB-DTPA and Sonazoid-CEUS was evaluated, the diagnostic sensitivity was increased to 93.5% in HCC nodules of 2 cm or less in diameter. Discussion. Gd-EOB-DTPA and Sonazoid-CEUS for HCC as liverspecific contrast agents showed higher sensitivity of diagnosis compared with 64-MDCT. The combined modality of Gd-EOBDTPA with Sonazoid-CEUS is a better choice for diagnosis of HCC. Funding. Nil. The authors declared no conflicts of interest. AOSOP3 EFFICACY OF CONCURRENT CHEMORADIOTHERAPY WITH CAPECITABINE AND CISPLATIN IN THE MANAGEMENT OF LOCALLY ADVANCED SQUAMOUS CELL CARCINOMA OF THE HEAD AND NECK S. Guptaa *, H. Khana , S. Barika , M.P.S. Negib . a Department of Radiotherapy, King George’s Medical University, Lucknow, Uttar Pradesh, India, b Institute of Data Computing and Training, Lucknow, Uttar Pradesh, India Introduction. We aimed to assess the efficacy and safety of concurrent capecitabine and cisplatin over concurrent cisplatin and fluorouracil in locally advanced squamous cell oral cancer. Methods. We randomly assigned 152 patients (all of whom had stage III or IV unresectable disease and had received two cycles of paclitaxel and cisplatin chemotherapy) to receive either concurrent cisplatin (75 mg/m2 on day 1 and day 2) and fluorouracil (750 mg/m2 on days 1, 2, 3) from the first day of radiotherapy at an interval of 3 weeks or cisplatin (75 mg/m2 on day 1 and day 2) and capecitabine (750 mg/m2 in two divided doses from day 1 to day 14) from the first day of radiotherapy at an interval of 3 weeks. Results. The study showed that the complete response of tumour, node, and overall in arm 1 was significantly higher (p < 0.05 or p < 0.01) compared with arm 2. Further, dose reduction and treatment delay were lowered significantly (p < 0.05 or p < 0.01) in arm 2 compared with arm 1. 3-year disease-free survival (c2 = 0.89, p = 0.346), progression-free survival (c2 = 2.59, p = 0.107), and overall survival (c2 = 1.45, p = 0.229) were similar in the two groups—ie, they did not differ significantly (p > 0.05), although they were 3.00 (hazard ratio (HR) 3.00, 95% confidence interval (CI) 0.30–30.58), 2.34 (HR 2.34, 95% CI 0.83–6.41), and 1.67 (HR 1.67, 95% CI 0.72–3.89) times higher in arm 2 compared with arm 1. The change in haemoglobin, weight, energy level, activity level, and overall quality of life of the two groups during the treatments and at end of the study were compared, showing that the levels of all variables were significantly different and higher in arm 2 compared with arm 1. Treatment-related acute and late
toxicities were similar between the two groups—ie, did not differ significantly (p > 0.05). Discussion. Concurrent chemoradiotherapy with capecitabine and cisplatin was found to be effective and can be regarded as an important regimen assuring the concerns of patients with locally advanced head and neck cancer. Funding. Nil. The authors declared no conflicts of interest. AOSOP4 PREOPERATIVE CONCURRENT CAPOX RADIOTHERAPY IN THAI PATIENTS WITH LOCALLY ADVANCED RECTAL CANCER E. Sirachainana *, C. Sitathaneec , S. Phongkitkarunc , W. Suwanthanmab , N. Larbcharoensubd , N. Trachue , S. Lukraka , K. Sumboonnanondab . a Department of Medicine, b Surgery, c Radiology, d Pathology, and e Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Introduction. The potential advantages of preoperative chemoradiotherapy in rectal cancer include pathological downstaging and reduced toxicity. Capecitabine and fluorouracil showed similar efficacy in preoperative concurrent chemoradiotherapy in locally advanced rectal cancer. Capecitabine in combination with oxaliplatin demonstrated efficacy for advanced colorectal cancer treatment. Methods. We conducted a phase 2 study to determine the efficacy and safety of preoperative concurrent CAPOX radiotherapy in Thai patients with locally advanced rectal cancer. Capecitabine 1650 mg/m2 per day was taken on days 1−14 and 22−35 of radiotherapy. Oxaliplatin 50 mg/m2 was administered on days 1, 8, 22, and 29 of radiotherapy. The radiation dose to the pelvis was 45 Gy/25 fractions with a boost dose of 5.4 Gy/3 fractions. The total dose to the tumour bed was 50.4 Gy/28 fractions. Clinical response was evaluated by MRI prior to surgery. Patients underwent surgery 4−6 weeks after completion of radiotherapy. The endpoints of this study were clinical response, pathological response, and toxicities. Results. Twenty patients have been enrolled. Median age was 59.5 years (range 37−72). Male:female ratio was 1.22:1. All patients had clinical T3 N positive disease except one who hadT4 disease. After receiving concurrent chemoradiotherapy, severe toxicities (diarrhoea, fatigue, anorexia, and neuropathy) were found in four patients (20%). One patient refused surgery after preoperative treatment. Response rate was evaluated in 18 patients. Clinical response rate was 83.4% (cCR 55.6%). Pathological response rate was 70.6% (pCR 5.9%). Eleven patients had microscopic residual disease. Most patients received adjuvant chemotherapy. Two patients developed recurrent disease and finally died. Discussion. Neoadjuvant concurrent capecitabine-oxaliplatin radiotherapy in Thai patients with locally advanced rectal cancer demonstrated excellent response rate and tolerable toxicities. Funding. None declared. The authors declared no conflicts of interest.