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Treatment Related Toxicity of Induction Chemotherapy Followed By Concurrent Chemoradiotherapy, Surgery And Adjuvant Chemotherapy For Treatment of Locally Advanced Rectal Cancer

Moamna Mohammed Fahmy*, Ahmad Alhosainy, Abdel Motaleb Mohammed,Basant  Sh.Elshafaay

Department of Clinical Oncology & Nuclear medicine, Faculty of Medicine - Zagazig University, Egypt.

Author: Moamna Mohammed Fahmy, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.           Mobile: +2 01026242420


Introduction: Colorectal cancer the third most commonly diagnosed cancer in males and second in females, according to GLOBOCAN database. In the United States, annually about 149.500 new cases of large basal cancer are diagnosed, 104.270 are colon cancer, and the remainder are rectal. (1).

Aim: decreasing toxicity of induction chemotherapy followed by concurrent chemoradiation, surgery and adjuvant chemotherapy in locally advanced cancer rectum.

Method: 38 locally advanced cancer rectum patients received neoadjuvant 3 cycles chemotherapy Folfox-4 then concurrent chemoradiotherapy (CCRT) with capecitabine (median 825 mg/m2/d BID) and conventional fractionated radiotherapy (total dose of 45Gy was given in 5weeks), then surgery then 3 cycles adjuvant chemotherapy Folfox-4.

Results: As regard neoadjuvant chemotherapy (G1) (Anemia 60.5%, thrombocytopenia 47.4%, leukopenia 23.7%, diarrhea 34.2%, mucositis 23.2%), (G2) (Anemia 21.1%, thrombocytopenia 13.2%, leukopenia 23.7%, diarrhea 15.8%, mucositis 34.2%), (G3) (leukopenia 2.6%, thrombocytopenia 2.6% and mucositis 2.6%), No(G4) toxicity was detected. for CCRT was (G1) (Anemia 57.8%, leukopenia 44.7%, thrombocytopenia 47.3%, diarrhea 44.7%, mucositis 26.3%, urinary symptoms 21%), (G2) (Anemia 26.3%, thrombocytopenia 21%, leukopenia 21%, diarrhea 26.3%, mucositis 23.6%, urinary sump 42%), (G3) (leukopenia 2.6% and diarrhea 2.6%), No G4 toxicity was detected. Adjuvant chemotherapy toxicities as (G1) (Anemia 50%, thrombocytopenia 47.3%, leukopenia 52.6%, diarrhea 44.7%, mucositis 42.1%), (G2) (Anemia 7.9%, thrombocytopenia 10.5%, leukopenia 10.5%, diarrhea 13.1%, mucositis 21%), (G3) (leukopenia 2.6% and thrombocytopenia 2.6%), No G4 toxicity was detected.

Conclusion: For locally advanced rectal cancer, this protocol is safe with effective local control that may increase use of neoadjuvant treatment for locally advanced rectal cancer.