Rectal cancer 5-fluorouracil

Minsky BD, Cohen AM, Kemeny N, et al. Enhancement of radiation-induced downstaging of rectal cancer by fluorouracil and high-dose leucovorin chemotherapy. J Clin Oncol 1992 10 79-84. 

O Connell MJ, Martenson JA, Wieand HS, et al. Improving adjuvant therapy for rectal cancer by combining protracted- infusion fluorouracil with radiation therapy after curative surgery. N Engl J Med 1994 331(8) 502-507. 

Janjan NA, Crane CN, Feig BW, et al. Prospective trial of preoperative concomitant boost radiotherapy with continuous infusion 5 -fluorouracil for locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 2000 47 713-718. 

Tepper JE, O Connell MJ, Petroni GR, et al. Adjuvant postoperative fluorouracil-modulated chemotherapy combined with pelvic radiation therapy for rectal cancer initial results of Intergroup 0114. J Clin Oncol 1997 15(5) 2030-2039. 

Willett CG, Hagan M, Daley W, et al. Changes in tumor proliferation of rectal cancer induced by preoperative 5-fluorouracil and irradiation. Dis Colon Rectum 1998 41 62-67. 

T. Leong, D. Lim-Joon, J. Mackay, D. Rischin, Oxaliplatin combined with infusional 5-fluorouracil and concomitant radiotherapy in inoperable and metastatic rectal cancer A phase I trial, Br. J. Cancer 92(4) (2005) 655-661. 

The Mayo/NCCTG trial compared postoperative XRT alone, postoperative XRT with concurrent fluorouracil plus semustine chemotherapy, and pre- and postirradiation chemotherapy in a similar population of 204 patients with rectal cancer. This was the first randomized trial in which one cycle of combination chemotherapy was given before and after XRT in addition to the administration of fluorouracil during XRT. The use of combined chemotherapy and XRT significantly affected local recurrence, relapse-free survival, and OS as compared to XRT alone. Patients receiving combined therapy experienced an overall relative reduction of recurrence of 34% at... 

In most clinical situations, chemotherapy augments the radiation-induced cell kill within the irradiated volume and may improve distant control. To maximize augmentation of cell kill, optimization of parameters of drug exposure is necessary. It has been shown, for example, that continuous infusion is better than bolus administration of 5-fluorouracil. The following example illustrates the efficacy of chemotherapy as a radiation enhancer. In the large randomized FFCD 9203 trial in rectal cancer preoperative radiotherapy (45 Gy in 25 fractions) resulted in a pCR in 4%, whereas the ad-... 

Marsh RD, Chu NM, Vauthey JN, et al. Preoperative treatment of patients with locally advanced unresectable rectal adenocarcinoma utilizing continuous chronobiologically shaped 5-fluorouracil infusion and radiation therapy. Cancer 1996 78(2) 217-225. 

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