Oxaliplatin-based adjuvant chemotherapy without radiotherapy can improve the survival of locally-advanced rectal cancer

Jun Li; Yue Liu; Jian-Wei Wang; Yang Gao; Ye-Ting Hu; Jin-Jie He; Xiu-Yan Yu; Han-Guang Hu; Ying Yuan; Su-Zhan Zhang; Ke-Feng Ding

doi:10.1371/journal.pone.0107872

Oxaliplatin-based adjuvant chemotherapy without radiotherapy can improve the survival of locally-advanced rectal cancer

PLoS One. 2014 Sep 22;9(9):e107872. doi: 10.1371/journal.pone.0107872. eCollection 2014.

Authors

Jun Li¹, Yue Liu², Jian-Wei Wang¹, Yang Gao², Ye-Ting Hu², Jin-Jie He¹, Xiu-Yan Yu¹, Han-Guang Hu³, Ying Yuan³, Su-Zhan Zhang¹, Ke-Feng Ding¹

Affiliations

¹ Department of Surgical Oncology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China; The Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Hangzhou, Zhejiang Province, China.
² The Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Hangzhou, Zhejiang Province, China.
³ The Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Hangzhou, Zhejiang Province, China; Department of Medical Oncology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.

Abstract

Objective: To assess the impact of oxaliplatin-containing adjuvant chemotherapy on the survival of patients with locally-advanced rectal cancer.

Methods: Data on patients with pathologically-confirmed T3/4 or N1/2 rectal cancer who accepted radical surgery at our center from January 2002 to June 2009 were reviewed retrospectively. The patients' 5-year overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) were analyzed by comparing those who accepted radical surgery only (Group S) with those who accepted radical surgery and oxaliplatin-containing adjuvant chemotherapy (Group SO).

Results: A total of 236 patients were analyzed (Group S 135; Group SO 101). Group S patients were older and had a higher proportion with stage II disease and more perioperative complications than those in Group SO (P<0.05). The OS and DSS of patients with stage III disease under 50 years of age or with mucinous adenocarcinoma were higher in Group SO than Group S (P<0.05). In addition, the OS of patients with stage N2b disease was higher in Group SO than Group S (P = 0.016), and the OS of patients with stage N1a or N2b disease who received more than 8 weeks of oxaliplatin-containing chemotherapy was also higher in Group SO than Group S (P<0.05). Although the OS and DSS of patients with stage II disease in Group SO showed a tendency towards improvement, the differences between the groups were not statistically significant.

Conclusion: Adjuvant oxaliplatin-containing chemotherapy can improve the survival of patients with locally-advanced low and middle rectal cancers in comparison with observation. Randomized, prospective trials are warranted to confirm this benefit of oxaliplatin for rectal cancer.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Antineoplastic Agents / therapeutic use*
Chemotherapy, Adjuvant
Female
Humans
Male
Middle Aged
Organoplatinum Compounds / therapeutic use*
Oxaliplatin
Rectal Neoplasms / drug therapy*
Rectal Neoplasms / pathology
Survival Rate

Substances

Antineoplastic Agents
Organoplatinum Compounds
Oxaliplatin

Grants and funding

This work was supported by the National Natural Science Foundation of China (No. 81301890, http://www.nsfc.gov.cn/) and Zhejiang Provincial Natural Science Foundation of China (No. LY13H160010, http://www.zjnsf.gov.cn/index.aspx). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.