Oxaliplatin-containing Preoperative Therapy in Locally Advanced Rectal Cancer: Local Response, Toxicity and Long-term...

Area of Science:

• Oncology
• Surgical Oncology
• Medical Oncology

Background:

• Locally advanced rectal cancer (LARC) requires effective neoadjuvant therapies to improve outcomes.
• Oxaliplatin has shown promise in enhancing chemotherapy regimens for various cancers.

Purpose of the Study:

• To evaluate oxaliplatin as an intensifying agent in sequential neoadjuvant therapy for LARC.
• To assess the impact on local tumor response and metastatic outcomes.

Main Methods:

• A non-randomized study involving 97 LARC patients (T2-3 and T4 stages).
• Sequential neoadjuvant therapy included initial Nordic FLOX (oxaliplatin, 5-fluorouracil, folinic acid) followed by chemoradiotherapy (oxaliplatin, capecitabine) and surgery.
• Toxicity, local tumor response, and long-term outcomes were meticulously recorded.

Main Results:

• 72% of patients achieved good histologic tumor regression.
• 95% received the full radiation dose with acceptable toxicity.
• Estimated 5-year progression-free survival was 61%, and overall survival was 83%.

Conclusions:

• Sequential oxaliplatin-containing neoadjuvant therapy is effective in LARC, yielding high response and survival rates.
• T4 stage tumors demonstrated inferior local response and long-term outcomes.
• The T4 stage appears biologically heterogeneous, suggesting potential for individualized therapy approaches.