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Research ArticleClinical Studies

Hypofractionated Accelerated Radiotherapy, Cytoprotection and Capecitabine in the Treatment of Rectal Cancer: A Feasibility Study

MICHAEL I. KOUKOURAKIS, CONSTANTINOS SIMOPOULOS, MICHAEL PITIAKOUDIS, NIKOLAOS LYRATZOPOULOS, KONSTANTINOS ROMANIDIS, ALEXANDRA GIATROMANOLAKI, ALEXANDROS POLYCHRONIDIS, GEORGE KOUKLAKIS, EFTHIMIOS SIVRIDIS, GEORGE MINOPOULOS and KONSTANTINOS MANOLAS
Anticancer Research September 2008, 28 (5B) 3035-3040;
MICHAEL I. KOUKOURAKIS
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  • For correspondence: targ@her.forthnet.gr
CONSTANTINOS SIMOPOULOS
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MICHAEL PITIAKOUDIS
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NIKOLAOS LYRATZOPOULOS
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KONSTANTINOS ROMANIDIS
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ALEXANDRA GIATROMANOLAKI
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ALEXANDROS POLYCHRONIDIS
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GEORGE KOUKLAKIS
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EFTHIMIOS SIVRIDIS
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GEORGE MINOPOULOS
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KONSTANTINOS MANOLAS
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Abstract

Background: This is a report on the feasibility and efficacy of hypofractionated accelerated radiotherapy combined with amifostine cytoprotection (hypoARC) and capecitabine in the treatment of rectal adenocarcinoma. Patients and Methods: Twenty-seven patients (pts) received pre- (14 pts) or postoperative (13 pts) conformal radiotherapy with 10 consecutive fractions of 3.4 Gy in 12 days, supported with subcutaneously administered high-dose amifostine (up to 1000 mg) and capecitabine (daily dose of 600 mg/m2 twice a day, 5 days per week for 4 weeks). Ten additional patients with inoperable tumors received a higher dose (15 fractions of 3.4 Gy) as a radical intervention and 5 received a lower dose for palliation. Results: Chemotherapy-related toxicity was minimal and radiation grade 2 diarrhoea and proctitis was noted in 3/42 and 4/42 cases, respectively. No peri- or postoperative complications were noted in patients receiving pre-operative radiochemotherapy. Significant tumor regression was confirmed in post-RT CT-imaging and major histological responses were noted in 85% of cases treated before surgery. Late toxicity (median follow-up 26 months) was negligible. The 2-year local relapse-free survival was 85-90% in patients treated with pre- or postoperative radiotherapy and 35% in patients with inoperable tumors. Conclusion: Capecitabine-based hypoARC is feasible with only minimal early and late toxicity and encouraging efficacy.

  • Capecitabine
  • radiotherapy
  • surgery
  • acceleration
  • hypofractionation
  • amifostine
  • rectal cancer

Footnotes

  • Received April 10, 2008.
  • Revision received June 18, 2008.
  • Accepted July 1, 2008.
  • Copyright© 2008 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved
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Anticancer Research: 28 (5B)
Anticancer Research
Vol. 28, Issue 5B
September-October 2008
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Hypofractionated Accelerated Radiotherapy, Cytoprotection and Capecitabine in the Treatment of Rectal Cancer: A Feasibility Study
MICHAEL I. KOUKOURAKIS, CONSTANTINOS SIMOPOULOS, MICHAEL PITIAKOUDIS, NIKOLAOS LYRATZOPOULOS, KONSTANTINOS ROMANIDIS, ALEXANDRA GIATROMANOLAKI, ALEXANDROS POLYCHRONIDIS, GEORGE KOUKLAKIS, EFTHIMIOS SIVRIDIS, GEORGE MINOPOULOS, KONSTANTINOS MANOLAS
Anticancer Research Sep 2008, 28 (5B) 3035-3040;

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Hypofractionated Accelerated Radiotherapy, Cytoprotection and Capecitabine in the Treatment of Rectal Cancer: A Feasibility Study
MICHAEL I. KOUKOURAKIS, CONSTANTINOS SIMOPOULOS, MICHAEL PITIAKOUDIS, NIKOLAOS LYRATZOPOULOS, KONSTANTINOS ROMANIDIS, ALEXANDRA GIATROMANOLAKI, ALEXANDROS POLYCHRONIDIS, GEORGE KOUKLAKIS, EFTHIMIOS SIVRIDIS, GEORGE MINOPOULOS, KONSTANTINOS MANOLAS
Anticancer Research Sep 2008, 28 (5B) 3035-3040;
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