Efficacy and safety of radiotherapy combined with raltitrexed and irinotecan for treating unresectable recurrent colorectal cancer: a single-arm phase II trial

doi:10.21037/jgo-22-308

	Efficacy and safety of radiotherapy combined with raltitrexed and irinotecan for treating unresectable recurrent colorectal cancer: a single-arm phase II trial
	Li, Xinghui 3,4; Shen, Jinwen 1,2,5; Xia, Fan 3,4; Zhu, Ji 1,2,5
刊名	JOURNAL OF GASTROINTESTINAL ONCOLOGY
	2022-04-28
关键词	Colorectal cancer local recurrence intensity-modulated radiotherapy irinotecan raltitrexed
ISSN号	2078-6891
DOI	10.21037/jgo-22-308
通讯作者	Xia, Fan(tcxiafan@hotmail.com) ; Zhu, Ji(leoon.zhu@gmail.com)
英文摘要	Background: Local recurrence of colorectal cancer is associated with poor prognosis and quality of life. For patients not eligible for curative surgery, chemoradiation could be a promising therapeutic option, but there is no consensus yet for the concurrent chemotherapy regimen. This study evaluated the effects and safety of intensity-modulated radiation therapy (IMRT) when administered concurrently with raltitrexed and irinotecan to patients with unresectable recurrent colorectal cancer. Methods: Eligible patients developed unresectable recurrent colorectal cancer, and were refractory to, or intolerant of, chemotherapy with fiuoropyrimidine and oxaliplatin. IMRT was delivered (total dose: 50-60 Gy in 25-30 fractions) concurrently with irinotecan and raltitrexed (200 and 3 mg/m(2), respectively, on days 1 and 22). After treatment completion, patients underwent surgery or continued the same regimen of chemotherapy and were assessed by a multidisciplinary team. The primary endpoint was the objective response rate, defined as the proportion of patients with a confirmed complete response or partial response, assessed by radiologist and investigator after the completion of radiotherapy and reconfirmed a month later, in accordance with the Response Evaluation Criteria in Solid Tumors version 1.1. Results: All 30 patients enrolled in this study between January 2019 and July 2020 completed radiotherapy and received a median of five chemotherapy cycles (range, 2-10 cycles). Twelve patients (40.0%) experienced an objective response (two complete responses and ten partial responses) and 17 patients exhibited stable disease [disease control rate (DCR): 96.7%]. The median follow-up was 22 months (range, 4-35 months), by the end of follow-up, six (20.0%) patients had local failure in the irradiation field, four (13.3%) had regional progression outside the irradiation field, 13 (43.3%) had distant metastasis or metastatic progression and nine (30.0%) died. The median progression-free survival (PFS) and local PFS (LPFS) were 13.5 and 23 months, respectively. The incidence of grade 3 or 4 adverse events was 26.7%, the most common of which was neutropenia (13.3%). Conclusions: IMRT with concurrent raltitrexed and irinotecan is a feasible treatment for unresectable recurrent colorectal cancer, which allows good tumor response and local control with acceptable toxicity profile.
WOS关键词	RECTAL-CANCER ; 2ND-LINE TREATMENT ; LOCAL RECURRENCE ; PLUS IRINOTECAN ; CHEMOTHERAPY ; CHEMORADIATION ; REIRRADIATION ; FLUOROURACIL ; MULTICENTER ; BEVACIZUMAB
WOS研究方向	Oncology ; Gastroenterology & Hepatology
语种	英语
出版者	AME PUBL CO
WOS记录号	WOS:000798254300001
内容类型	期刊论文
源URL	[http://ir.hfcas.ac.cn:8080/handle/334002/130893]
专题	中国科学院合肥物质科学研究院
通讯作者	Xia, Fan; Zhu, Ji
作者单位	1.Univ Chinese Acad Sci, Zhejiang Canc Hosp, Canc Hosp, Hangzhou 310022, Peoples R China 2.Zhejiang Key Lab Radiat Oncol, Hangzhou 310022, Peoples R China 3.Fudan Univ, Dept Radiat Oncol, Shanghai Canc Ctr, Shanghai 200032, Peoples R China 4.Fudan Univ, Shanghai Med Coll, Dept Oncol, Shanghai 200032, Peoples R China 5.Chinese Acad Sci, Inst Canc & Basic Med IBMC, Hangzhou 310000, Peoples R China
推荐引用方式 GB/T 7714	Li, Xinghui,Shen, Jinwen,Xia, Fan,et al. Efficacy and safety of radiotherapy combined with raltitrexed and irinotecan for treating unresectable recurrent colorectal cancer: a single-arm phase II trial[J]. JOURNAL OF GASTROINTESTINAL ONCOLOGY,2022.
APA	Li, Xinghui,Shen, Jinwen,Xia, Fan,&Zhu, Ji.(2022).Efficacy and safety of radiotherapy combined with raltitrexed and irinotecan for treating unresectable recurrent colorectal cancer: a single-arm phase II trial.JOURNAL OF GASTROINTESTINAL ONCOLOGY.
MLA	Li, Xinghui,et al."Efficacy and safety of radiotherapy combined with raltitrexed and irinotecan for treating unresectable recurrent colorectal cancer: a single-arm phase II trial".JOURNAL OF GASTROINTESTINAL ONCOLOGY (2022).