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ASTRO: New Chemo, Radiation Combo Suggested in Rectal Cancer

Patients have 88 percent chance of survival at three years with capecitabine, radiation at 50 Gy

MONDAY, Oct. 3 (HealthDay News) -- For patients with rectal cancer, preoperative treatment with a combination of capecitabine and radiation at 50 Gy is associated with favorable outcomes at three years, according to a study presented at the annual meeting of the American Society for Radiation Oncology, held from Oct. 2 to 6 in Miami Beach.

Jean Pierre Gerard, M.D., from the Center Antoine-Lacassagne in Nice, France, and colleagues compared a combination of two different chemotherapies and two different radiation doses (five-week regimen) to identify a safe and effective preoperative treatment for rectal cancer. A total of 598 patients with locally advanced rectal cancer were selected from 2005 to 2008 and received either Cap45 (capecitabine, and radiation treatment at 45 Gy) or Capox50 (capecitabine and oxaliplatin, along with radiation at 50 Gy).

The investigators found that patients treated with Capox50 before surgery had an 88 percent chance of survival at three years after treatment. Capox50 did not significantly increase the chances of cancer recurrence or survival, compared with Cap45. Increasing the radiation dose from 45 to 50 Gy in five weeks was found to be effective and well-tolerated, and it did not extend the duration of treatment. Oxaliplatin was associated with increased immediate side effects, including severe diarrhea, and was ineffective in increasing the chance of local tumor sterilization.

"The results of the trial allow us to recommend a new preoperative treatment, the CAP 50 regimen, in locally advanced rectal cancer," Gerard said in a statement.

Gerard disclosed an advisory relationship with Ariane Medical Systems, which designs and builds radiation therapy equipment for the treatment of cancers.

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