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Liao CK, Kuo YT, Chern YJ, Hsu YJ, Lin YC, Yu YL, Hsieh PS, Chiang JM, Yeh CY, You JF. Tegafur-Uracil/Leucovorin Plus Oxaliplatin ( TEGAFOX) as Consolidation Regimen after Short-Course Radiotherapy Is Effective for Locally Advanced Rectal Cancer. J Clin Med 2022; 11:jcm11102920. [PMID: 35629045 PMCID: PMC9146085 DOI: 10.3390/jcm11102920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/26/2022] [Accepted: 05/20/2022] [Indexed: 11/25/2022] Open
Abstract
This study aimed to explore the safety and efficacy of neoadjuvant SCRT and tegafur−uracil/leucovorin plus oxaliplatin (TEGAFOX) for LARC in comparison to those of the modified 5-fluorouracil, leucovorin, and oxaliplatin (mFOLFOX-6) regimen. We retrospectively evaluated 15 and 22 patients with LARC who underwent SCRT, followed by consolidation chemotherapy with TEGAFOX and mFOLFOX-6 before surgery, respectively, between January 2015 and December 2019. The primary endpoint was the tumor response rate. The secondary endpoints were compliance, toxicity, complications, overall survival (OS), and disease-free survival (DFS). The dose reduction rate was lower in the TEGAFOX group (0 vs. 9.1% (n = 2)). No grade III-IV toxicities occurred in the TEGAFOX group. Two and four patients in the TEGAFOX and mFOLFOX-6 groups, respectively, achieved clinical complete responses. The pathologic complete response rate was lower in the TEGAFOX group (7.7% vs. 17.6%). Overall, 11 (73.3%) and 17 (81.0%) patients had a neoadjuvant rectal (NAR) score of <16 in the TEGAFOX and mFOLFOX-6 groups, respectively. All patients in this study received sphincter-preservation surgery. One patient in each group developed Clavien−Dindo grade III complications. There were no significant between-group differences in the 3-year OS (81.8% vs. 84.8%, p = 0.884) and 3-year DFS (72% vs. 71.6%, p = 0.824) rates. TEGAFOX, as consolidation chemotherapy after SCRT, achieves good tumor downstaging and patient compliance in LARC. The toxicity, complications, and surgical outcomes are similar to those of mFOLFOX-6. Thus, TEGAFOX can be considered a chemotherapy option for rectal cancer treatment.
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Affiliation(s)
- Chun-Kai Liao
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing Street, Guishan District, Taoyuan 333423, Taiwan; (C.-K.L.); (Y.-T.K.); (Y.-J.C.); (Y.-J.H.); (Y.-C.L.); (P.-S.H.); (J.-M.C.); (C.-Y.Y.)
| | - Ya-Ting Kuo
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing Street, Guishan District, Taoyuan 333423, Taiwan; (C.-K.L.); (Y.-T.K.); (Y.-J.C.); (Y.-J.H.); (Y.-C.L.); (P.-S.H.); (J.-M.C.); (C.-Y.Y.)
| | - Yih-Jong Chern
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing Street, Guishan District, Taoyuan 333423, Taiwan; (C.-K.L.); (Y.-T.K.); (Y.-J.C.); (Y.-J.H.); (Y.-C.L.); (P.-S.H.); (J.-M.C.); (C.-Y.Y.)
| | - Yu-Jen Hsu
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing Street, Guishan District, Taoyuan 333423, Taiwan; (C.-K.L.); (Y.-T.K.); (Y.-J.C.); (Y.-J.H.); (Y.-C.L.); (P.-S.H.); (J.-M.C.); (C.-Y.Y.)
| | - Yueh-Chen Lin
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing Street, Guishan District, Taoyuan 333423, Taiwan; (C.-K.L.); (Y.-T.K.); (Y.-J.C.); (Y.-J.H.); (Y.-C.L.); (P.-S.H.); (J.-M.C.); (C.-Y.Y.)
| | - Yen-Lin Yu
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Keelung Branch, No. 222, Maijin Road, Anle District, Keelung City 204201, Taiwan;
| | - Pao-Shiu Hsieh
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing Street, Guishan District, Taoyuan 333423, Taiwan; (C.-K.L.); (Y.-T.K.); (Y.-J.C.); (Y.-J.H.); (Y.-C.L.); (P.-S.H.); (J.-M.C.); (C.-Y.Y.)
- School of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan 333323, Taiwan
| | - Jy-Ming Chiang
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing Street, Guishan District, Taoyuan 333423, Taiwan; (C.-K.L.); (Y.-T.K.); (Y.-J.C.); (Y.-J.H.); (Y.-C.L.); (P.-S.H.); (J.-M.C.); (C.-Y.Y.)
- School of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan 333323, Taiwan
| | - Chien-Yuh Yeh
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing Street, Guishan District, Taoyuan 333423, Taiwan; (C.-K.L.); (Y.-T.K.); (Y.-J.C.); (Y.-J.H.); (Y.-C.L.); (P.-S.H.); (J.-M.C.); (C.-Y.Y.)
- School of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan 333323, Taiwan
| | - Jeng-Fu You
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing Street, Guishan District, Taoyuan 333423, Taiwan; (C.-K.L.); (Y.-T.K.); (Y.-J.C.); (Y.-J.H.); (Y.-C.L.); (P.-S.H.); (J.-M.C.); (C.-Y.Y.)
- School of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan 333323, Taiwan
- Correspondence: ; Tel.: +886-975365617
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Kosugi C, Koda K, Takiguchi N, Takaishi S, Miyauchi H, Hirayama N, Nomura Y, Kondo E, Kawasaki Y, Ozawa Y, Matsubara H. Randomized phase II study of tegafur-uracil/leucovorin versus tegafur-uracil/leucovorin plus oxaliplatin after curative resection of high-risk stage II/III colorectal cancer (SOAC-1101 trial). Int J Colorectal Dis 2021; 36:1739-1749. [PMID: 33715077 DOI: 10.1007/s00384-021-03906-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE This randomized phase II trial compared tegafur-uracil/leucovorin (UFT/LV) plus oxaliplatin (TEGAFOX) to UFT/LV as adjuvant chemotherapy for patients with high-risk stage II/III colorectal cancer. METHODS From 2010 to April 2015, 159 patients who underwent curative resection were randomly assigned to receive TEGAFOX (85 mg/m2 oxaliplatin on days 1 and 15, 300 mg/m2/day UFT and 75 mg/day LV on days 1-28, every 35 days for five cycles) or UFT/LV. The primary study endpoint was disease-free survival. RESULTS The 3-year disease-free survival rate was 84.2% in the TEGAFOX arm, versus 62.1% for UFT/LV. The stratified hazard ratio for disease-free survival for TEGAFOX compared to UFT/LV was 0.338 (P < 0.01). The incidence of any-grade adverse events was significantly higher in the TEGAFOX arm (96.1%) than in the UFT/LV arm (76.6%; P < 0.01). The rates of any-grade neutropenia, thrombocytopenia, aspartate aminotransferase/alanine aminotransferase elevation, and peripheral sensory neuropathy were higher in the TEGAFOX group, whereas the incidence of grade ≥ 3 adverse events did not differ between the groups. CONCLUSIONS TEGAFOX is an additional adjuvant chemotherapy option for high-risk stage II/III colorectal cancer. TRIAL REGISTRATION UMIN ID: 000007696, date of registration: April 10, 2012.
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Affiliation(s)
- Chihiro Kosugi
- Department of Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan.
| | - Keiji Koda
- Department of Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan
| | | | - Satoru Takaishi
- Department of Surgery, Seikei-kai Chiba Medical Center, Chiba, Japan
| | - Hideaki Miyauchi
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Nobuo Hirayama
- Department of Surgery, Kumagaya General Hospital, Kumagaya, Saitama, Japan
| | - Yukihiro Nomura
- Department of Surgery, Asahi General Hospital, Asahi, Chiba, Japan
| | - Eisuke Kondo
- Department of Surgery, Japanese Red Cross Narita Hospital, Narita, Chiba, Japan
| | - Yohei Kawasaki
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yoshihito Ozawa
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Hisahiro Matsubara
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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