Low-dose chemotherapy is practically useful for the patients with intrapelvic recurrence of rectal cancer

The aim was to assess the practical efficacy of low-dose chemotherapy in patients with intrapelvic recurrence of rectal cancer without radiotherapy.

The records of 13 patients treated with low-dose chemotherapy for intrapelvic recurrence of rectal cancer between 1996 and 2003 were retrospectively reviewed. The patients had received low-dose leucovorin and 5-fluorouracil (LV/5-FU) as first-line and low-dose irinotecan and cisplatin regimen (CPT-11/CDDP) as second-line therapy without radiotherapy.

With the LV/5-FU treatment, no patients showed a complete response (CR), two patients showed a partial response (PR), three patients had stable disease (SD), and eight patients experienced progressive disease (PD), giving a response rate (RR) of 15.4% and a disease control rate (DCR) of 38.5%. With the CPT-1/CDDP treatment, no patients showed CR or PR, three patients had SD, and ten patients had PD, which results in a DCR of 23.1%. The progression-free survival (PFS) of LV/5-FU and CPT-11/CDDP were 4.7 months and 4.7 months respectively. The median survival time (MST) of all the patients was 17.3 months. There were no patients who experienced grade 3 or 4 of any adverse reaction during the course of these regimens.

The results suggest that low-dose chemotherapy for intrapelvic recurrence of rectal cancer without radiotherapy could be acceptable. For patients who refused radiotherapy in order to avoid adverse effects, these low-dose low toxicity chemotherapy regimens might be recommended.