DOI: 10.36347/sajb.2015.v03i05.008

Pages: 464-467

In order to selecting optimal treatment regimen in patients suffered advanced rectal cancer, combined adjuvant radiochemotherapy has been found to be more effective than radiotherapy or surgery alone. 5-fluorouracil (5-FU) given concomitantly within the first week of radiotherapy has been shown to be potentially effective, especially before surgical resection of tumor. In the present study, we planned a regimen including preoperative 5-FU infusion within 8 hours concurrently with radiotherapy to assess the efficacy of this protocol without needing hospitalization and with minimizing therapeutic regimen side effects in patients with locally advanced rectal cancer. Sixteen consecutive patients locally advanced rectal cancer (clinical stage T3–T4 or any T stage with positive nodal involvement) received 5FU delivered by continuous infusion within 8 hours, concomitantly with radiotherapy. 5FU dosage was planned at 1000 mg/m2 (ranged 1500 to 1800 mg). Patients were clinically examined and laboratory parameters were assessed every week for six weeks and then were operated. At the 5FU dose of 1000 mg/m2, 8 patients presenting with cytopenia that only 3 of them needed to subcutaneous injection of Neupogen. Gastrointestinal events including diarrhea was revealed in 6 patients that was improved by appropriate nutritional regimen and using Loperamide, but radiotherapy was stopped in other 2 patients. Five patients needed to blood transfusion because of the appearance of serum hemoglobin less than 8.5 g/dl. Two patients were administered to be rest at home for one week. All patients completed their treatment and underwent surgery 6 weeks later. The preoperative radiochemotherapy regimen used in the present study incurs a low rate of complications with an acceptable controlled morbidity.