Lokal ilerlemiş rektal karsinomalı hastalarda preoperatif radyoterapi ile birlikte verilen önerilmiş dozdaki raltitrexed'in tedaviye cevabı

Abstract

OBJECTIVES We aimed to evaluate the treatment response and toxic effects of the recommended dose of raltitrexed when delivered concurrently with preoperative radiotherapy in patients with locally advanced rectal carcinoma. METHODS This open-labeled, prospective and non-comparative study was conducted with 49 patients. Radiotherapy (50.4 Gy) was delivered in 1.8 Gy daily fractions five times per week for 5-6 weeks. Single doses of 2.6 mg/m2 raltitrexed were infused over 15 minutes 1 hour prior to radiotherapy on days 1 and 22. Treatment response and toxicity were clinically assessed by hematological and biochemical tests and World Health Organization performance status scoring. RESULTS Overall treatment response was 42.9%. Post-treatment resectability opportunity was achieved in 67.3% patients. Raltitrexed was found to be related to 52.6% of the total adverse events. CONCLUSION The combination of raltitrexed and radiotherapy appears promising as neoadjuvant therapy in patients with inoperable rectal cancer with higher but manageable gastrointestinal toxicity.

Keywords

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Lokal ilerlemiş rektal karsinomalı hastalarda preoperatif radyoterapi ile birlikte verilen önerilmiş dozdaki raltitrexed'in tedaviye cevabı

Öz

AMAÇ Bu çalışmada, lokal ilerlemiş rektal karsinomalı hastalarda preoperatif radyoterapi ile birlikte verilen önerilmiş dozdaki raltitrexed'in tedaviye cevabı ve toksik etkileri değerlendirildi. GEREÇ VE YÖNTEM Bu açık-etiketli, prospektif ve karşılaştırmalı olmayan çalışma 49 hasta üzerinde yürütüldü. 50.4 Gy radyoterapi 5-6 hafta süreyle haftada 5 kere 1.8 Gy'lik fraksiyone dozlar şeklinde verildi. Tek doz şeklinde 2.6 mg/m2 raltitrexed 1. ve 22. günlerde radyoterapiden 1 saat once 15 dakika süreyle infüze edildi. Tedaviye cevap ve toksisite klinik olarak hematolojik ve biyokimyasal testler ve Dünya Sağlık Örgütü performans skoru ile değerlendirildi. BULGULAR Tüm tedavi cevabı %42.9 idi. Tedavi sonrası rezektabilite oranı hastaların %67.3'ünde görüldü. Toplam advers olayların %52.6'sı raltitrexed'e bağlı bulundu. SONUÇ İnoperabl rektal kanserli hastalarda raltitrexed-radyoterapi birleşimi yüksek oranda ancak tedavi edilebilir gastrointestinal toksisite ile birlikte ümit verici bir neoadjuvan tedavi olarak gözükmektedir.

Anahtar Kelimeler

• Rektal kanser, raltitrexed, radyoterapi, yaşam süresi, toksisite

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